Influence of Ulnar Translation of the Radial Shaft in Distal Radius Fracture on Distal Radioulnar Joint Instability

 

 Permissions and Reprints

Abstract

It has been reported that the distal interosseous membrane (DIOM) of the forearm constrains the dorsal dislocation of the distal radius. A residual ulnar translation deformity of the radial shaft in distal radius fractures has the potential to cause distal radioulnar joint (DRUJ) instability when triangular fibrocartilage complex (TFCC) injury is also present, because it may result in detensioning of the DIOM. Correction of ulnar translation of the radial shaft is critical because it restores DIOM tension, which then firmly holds the ulnar head in the concavity of the sigmoid notch.

• References

• 1 Kihara H, Short WH, Werner FW, Fortino MD, Palmer AK. The stabilizing mechanism of the distal radioulnar joint during pronation and supination. J Hand Surg Am 1995; 20 (6) 930-936
  CrossrefPubMedGoogle Scholar
• 2 Ward LD, Ambrose CG, Masson MV, Levaro F. The role of the distal radioulnar ligaments, interosseous membrane, and joint capsule in distal radioulnar joint stability. J Hand Surg Am 2000; 25 (2) 341-351
  CrossrefPubMedGoogle Scholar
• 3 Stuart PR, Berger RA, Linscheid RL, An KN. The dorsopalmar stability of the distal radioulnar joint. J Hand Surg Am 2000; 25 (4) 689-699
  CrossrefPubMedGoogle Scholar
• 4 Watanabe H, Berger RA, Berglund LJ, Zobitz ME, An KN. Contribution of the interosseous membrane to distal radioulnar joint constraint. J Hand Surg Am 2005; 30 (6) 1164-1171
  CrossrefPubMedGoogle Scholar
• 5 Noda K, Goto A, Murase T, Sugamoto K, Yoshikawa H, Moritomo H. Interosseous membrane of the forearm: an anatomical study of ligament attachment locations. J Hand Surg Am 2009; 34 (3) 415-422
  CrossrefPubMedGoogle Scholar
• 6 Moritomo H, Noda K, Goto A, Murase T, Yoshikawa H, Sugamoto K. Interosseous membrane of the forearm: length change of ligaments during forearm rotation. J Hand Surg Am 2009; 34 (4) 685-691
  CrossrefPubMedGoogle Scholar
• 7 Kitamura T, Moritomo H, Arimitsu S , et al. The biomechanical effect of the distal interosseous membrane on distal radioulnar joint stability: a preliminary anatomic study. J Hand Surg Am 2011; 36 (10) 1626-1630
  CrossrefPubMedGoogle Scholar
• 8 Moritomo H. The distal oblique bundle of the distal interosseous membrane of the forearm. J Wrist Surg 2013; 2 (1) 93-94
  Article in Thieme ConnectPubMedGoogle Scholar
• 9 Omori S, Moritomo H, Murase T , et al. Changes in length of the radioulnar ligament and distal oblique bundle after Colles' fracture. J Plast Surg Hand Surg 2013; 47 (5) 409-414
  CrossrefPubMedGoogle Scholar
• 10 Jupiter JB. Commentary: the effect of ulnar styloid fractures on patient-rated outcomes after volar locking plating of distal radius fractures. J Hand Surg Am 2009; 34 (9) 1603-1604
  CrossrefPubMedGoogle Scholar
• 11 Ross M. Volar angle stable plating for distal radius fractures. In: Slutsky DJ, , ed. Principles and Practice of Wrist Surgery. Philadelphia, PA: WB Saunders; 2010: 133-136
  Google Scholar
• 12 Orbay JL. Ulnar head and styloid fractures. In: Slutsky DJ, , ed. Principles and Practice of Wrist Surgery. Philadelphia, PA: Saunders; 2010: 198-204
  Google Scholar
• 13 Rapley JH, Kearny JP, Schrayer A, Viegas SF. Ulnar translation, a commonly overlooked, unrecognized deformity of distal radius fractures: techniques to correct the malalignment. Tech Hand Up Extrem Surg 2008; 12 (3) 166-169
  CrossrefPubMedGoogle Scholar
• 14 Koh S, Andersen CR, Buford Jr WL, Patterson RM, Viegas SF. Anatomy of the distal brachioradialis and its potential relationship to distal radius fracture. J Hand Surg Am 2006; 31 (1) 2-8
  CrossrefPubMedGoogle Scholar