Current conceptThe Distal Interosseous Membrane: Current Concepts in Wrist Anatomy and Biomechanics
Section snippets
Anatomy of the DIOM
The DIOM is on the distal side of the middle ligamentous complex, spanning the radius and ulna under the region of the pronator quadratus muscle. A hole exists in that portion, through which the interosseous artery passes. Noda et al3 reported anatomical variation of the DIOM. The authors found that thickness of the DIOM varied widely among specimens, and identified the distal oblique bundle (DOB) in 12 of 30 specimens (40%) (FIGURE 1, FIGURE 2). The DOB is an obvious thick fiber running within
Length change during pronosupination
Moritomo et al6 investigated changes in the length of the IOM during forearm rotation in vivo. In that study, the author calculated the 3-dimensional lengths of the 5 ligaments in the IOM between attachments during forearm rotation using a markerless bone registration technique. They also examined relationships between the axis of forearm rotation and each ligament, and found that the distal 3 ligaments (central band, accessory band, and DOB) had little change in length during forearm rotation,
Discussion
The form of the ulnar side of the human wrist represents progressive evolutionary development. The embryological and clinical material suggests that there is a tremendous variation in the development of the ulnar side of the wrist. Recent studies have demonstrated anatomical variation of the DIOM, and the DOB was recognized as the exact fiber responsible for function of the DIOM. Biomechanical studies have shown that the DOB changed minimally in length during forearm rotation; therefore, it was
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