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Biomechanical comparison of transosseous re-fixation of the deep fibres of the distal radioulnar ligaments versus deep and superficial fibres: a cadaver study

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Abstract

Purpose

We hypothesized that the re-fixation of the deep and superficial fibres of the distal radioulnar ligaments provide improved stability compared to reconstruction of the deep fibres alone.

Methods

Fourteen fresh-frozen cadaver upper extremities were used for biomechanical testing. Transosseous re-fixation of the deep fibres of the distal radioulnar ligaments alone (single mattress suture group; n = 7) was compared to the transosseous re-attachment of the deep and superficial fibres (double mattress suture group; n = 7). Cyclic load application provoked palmar translation of the radius with respect to the rigidly affixed ulna. Creep, stiffness, and hysteresis were obtained from the load-deformation curves, respectively. Testing was done in neutral forearm rotation, 60° pronation, and 60° supination.

Results

The re-fixation techniques did not differ significantly regarding the viscoelastic parameters creep, hysteresis, and stiffness. Several significant differences of one cycle to the consecutive one within each re-fixation group could be detected especially for creep and hysteresis. No significant differences between the different forearm positions could be detected for each viscoelastic parameter.

Conclusions

The re-fixation techniques did not differ significantly regarding creep, hysteresis, and stiffness. This means that the additional re-attachment of the superficial fibres may not provide greater stability to the DRUJ. Bearing in mind that the study was a cadaver examination with a limited number of specimens we may suppose that the re-attachment of the superficial fibres seem to be unnecessary. A gradual decline of creep and hysteresis from first to last loading-unloading cycle is to be expected and typical of ligaments which are viscoelastic.

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Acknowledgments

We thank Mr. Thomas Bruckner, PhD, Department of Medical Biometry and Informatics, Heidelberg, Germany for his statistical advice.

We thank Mrs. Jutta Knifka, Department of Orthopaedics and Traumatology, University Hospital Cologne, Germany, for her relentless support.

Special thanks to Mr. Martin Külser-Feldker, Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Germany, for his great expertise.

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed were in accordance with the ethical standards of the institutional ethics committee and with the 1964 Helsinki declaration.

Funding

The study was supported by a grant of the Richard and Annemarie Wolf Foundation. The first author appreciates the financial support kindly.

Author information

Authors and Affiliations

  1. Department of Hand Surgery, Vulpius Klinik, Vulpiusstraße 29, 74906, Bad Rappenau, Germany

    Christian K. Spies & Frank Unglaub

  2. Cologne Center for Musculoskeletal Biomechanics (CCMB) Medical Faculty, University of Cologne, Joseph-Stelzmann-Str. 9, 50931, Köln, Germany

    Anja Niehoff

  3. Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Köln, Germany

    Anja Niehoff

  4. Medical Faculty Mannheim of the Ruprecht-Karls University Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany

    Frank Unglaub

  5. Department of Orthopaedics and Traumatology, University Hospital Cologne, Kerpener Str. 62, 50937, Köln, Germany

    Lars P. Müller & Johannes Oppermann

  6. Department of Orthopaedics and Traumatology, University Hospital Münster, Waldeyerstr. 1, 48129, Münster, Germany

    Martin F. Langer

  7. Department of Anatomy I, Medical Faculty, University of Cologne, Kerpener Str. 62, 50937, Köln, Germany

    Wolfram F. Neiss

Authors
  1. Christian K. Spies
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  2. Anja Niehoff
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  3. Frank Unglaub
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  4. Lars P. Müller
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  5. Martin F. Langer
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  6. Wolfram F. Neiss
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  7. Johannes Oppermann
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Corresponding author

Correspondence to Christian K. Spies.

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Fig. 4

a-b *Significantly (p < 0.05) different from the preceding cycle within the group (both groups: n = 7). c *Significantly (p < 0.05) different from the preceding cycle within the group (single mattress suture group: n = 7; double mattress suture group: n = 6) (DOCX 14 kb)

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Fig. 5

a *Significantly (p < 0.05) different from the preceding cycle within the group (single mattress suture group: n = 7; double mattress suture group: n = 6). b-c *Significantly (p < 0.05) different from the preceding cycle within the group (both groups: n = 7) (DOCX 14 kb)

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Fig. 6

a-c *Significantly (p < 0.05) different from the preceding cycle within the group (both groups: n = 7) (DOCX 14 kb)

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Fig. 7

a-c *Significantly (p < 0.05) different from the preceding cycle within the group (all groups: n = 7) (DOCX 16 kb)

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Fig. 8

a *Significantly (p < 0.05) different from the preceding cycle within the group (neutral: n = 7; pronation: n = 6; supination: n = 7). b *Significantly (p < 0.05) different from the preceding cycle within the group (all groups: n = 7). c *Significantly (p < 0.05) different from the preceding cycle within the group (neutral: n = 6; pronation: n = 7; supination: n = 7) (DOCX 16 kb)

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Spies, C.K., Niehoff, A., Unglaub, F. et al. Biomechanical comparison of transosseous re-fixation of the deep fibres of the distal radioulnar ligaments versus deep and superficial fibres: a cadaver study. International Orthopaedics (SICOT) 40, 315–321 (2016). https://doi.org/10.1007/s00264-015-2986-1

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  • DOI: https://doi.org/10.1007/s00264-015-2986-1

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