Original CommunicationsThe efficacy of magnetic resonance imaging and ultrasound in detecting disruptions of the forearm interosseous membrane: A cadaver study☆,☆☆,★
Section snippets
Materials and methods
Twenty fresh-frozen cadaver upper extremities amputated above the elbow were obtained and thawed to room temperature. The cadavers ranged in age from 21 to 58 years (mean age, 51 years). The specimens were then examined via fluoroscopy for evidence of prior bony injury. One arm was excluded because of obvious prior trauma, leaving 19 specimens for study.
In each specimen, the IOM was approached dorsally using a Thompson's approach. The IOM was first visualized but not transected (Fig. 1).
Results
In all specimens the thickened central portion of the IOM could easily be visualized by MRI (Fig. 1) before to experimental sectioning. During dissection it was noted that when the central portion of the IOM was cut, the edges immediately separated and volar forearm musculature protruded (Fig. 2).
The MRI appearance of the intact cadaveric central portion of the IOM is a thick bandlike structure obliquely extending from the radius (proximally) to the ulna (distally).7 The structure is thickest
Discussion
Acute IOM injury should be inferred by the simultaneous clinical identification of radial head fracture and distal radial ulnar joint injury. Unfortunately, the diagnosis of acute or chronic longitudinal radioulnar dissociation is often made late. In either situation the treatment is considered controversial. The anatomy, strength, and kinematics of the IOM have been described.6, 9, 10, 11 The central third of the IOM is a discrete thickening located at the midshaft level of the radius. This
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2019, Orthopaedics and TraumaCitation Excerpt :Ultrasound and MRI scans are very helpful in detecting IOM tears, especially in cases where clinical examination is suspicious, but radiographs are normal. There is no difference between the two modalities in term of specificity or sensitivity.27 The MRI has the added benefit of detecting TFCC tears and DRUJ congruence if the wrist is included.
Essex-Lopresti Injuries
2018, Morrey's The Elbow and Its Disorders
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No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
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The views expressed in this article are those of the authors and do not reflect the official policy of the Department of Defense or other Departments of the United States Government.
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Reprint requests: Peter M. Murray, MD, Department of Orthopaedic Surgery/Division of Hand and Microsurgery, Mayo Clinic, 4500 San Pablo Rd, Jacksonville, FL 32224.