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DOI: 10.1055/s-0035-1545348
The Function of the Distal Interosseous Membrane and its Relevance to the Stability of the Distal Radioulnar Joint: An Anatomical and Biomechanical Review
Die Funktion des distalen Anteils der Membrana interossea und ihre Bedeutung für die Stabilität des distalen Radioulnargelenks: ein anatomischer und biomechanischer ÜberblickPublication History
received 13 June 2014
accepted 01 February 2015
Publication Date:
04 May 2015 (online)
![](https://www.thieme-connect.de/media/hamipla/201505/lookinside/thumbnails/2014-06-0700-83_10-1055-s-0035-1545348-1.jpg)
Abstract
The purpose of this article is to review functional anatomy and biomechanics of the distal interosseous membrane (DIOM) and its relevance to the stability of the distal radioulnar joint. The intact DIOM constrained dorsal dislocation of the radius, but it seldom constrained palmar dislocation. A residual ulnar translation deformity of the radial shaft in distal radius fractures has the potential to cause the distal radioulnar joint instability when the triangular fibrocartilage complex injury is also present, because it may result in detensioning of DIOM. Ulnar shortening with the osteotomy performed proximal to the attachment of the DIOM had a more favorable effect on stability of the DRUJ compared with the effect of distal osteotomy, especially in the presence of the distal oblique bundle (DOB). The longitudinal resistance to ulnar shortening was significantly greater in proximal shortening than in distal shortening.
Zusammenfassung
Dieser Artikel gibt einen Überblick über die funktionelle Anatomie und Biomechanik des distalen Anteils der Membrana interossea (DMIO) sowie deren Bedeutung für die Stabilität des distalen Radioulnargelenks. Die intakte DMIO verhindert zwar eine dorsale Luxation des Radius, aber selten die palmare. Bei Frakturen des distalen Radius kann eine verbleibende Translationsfehlstellung des Schaftes nach ulnar zu einer Instabilität des distalen Radioulnargelenks führen, vor allem wenn auch eine Verletzung des triangulären fibrokartilaginären Komplexes vorliegt, da diese Fehlstellung zum Spannungsverlust der DMIO führen kann. Die Durchführung einer Verkürzungsosteotomie der Elle proximal des Ursprunges der DMIO wirkt sich stabilisierender auf das distale Radioulnargelenk aus als eine Osteotomie distal davon, insbesondere beim Vorhandensein einer distalen Chorda obliqua (distal oblique bundle = DOB). Der Widerstand beim Schluss des Osteotomiespaltes der Ellenverkürzung ist bei proximal gelegener Osteotomie deutlich größer als bei der distalen.
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References
- 1 Kihara H, Short WH, Werner FW et al. The stabilizing mechanism of the distal radioulnar joint during pronation and supination. J Hand Surg Am 1995; 20: 930-936
- 2 Ward LD, Ambrose CG, Masson MV et al. The role of the distal radioulnar ligaments, interosseous membrane, and joint capsule in distal radioulnar joint stability. J Hand Surg Am 2000; 25: 341-351
- 3 Stuart PR, Berger RA, Linscheid RL et al. The dorsopalmar stability of the distal radioulnar joint. J Hand Surg Am 2000; 25: 689-699
- 4 Watanabe H, Berger RA, Berglund LJ et al. Contribution of the interosseous membrane to distal radioulnar joint constraint. J Hand Surg Am 2005; 30: 1164-1171
- 5 Nakamura T, Matsumura N, Iwamoto T et al. Arthroscopy of the distal radioulnar joint. Handchir Mikrochir Plast Chir 2014; 46: 295-299
- 6 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: 1603-1604
- 7 Orbay JL. Ulnar head and styloid fractures. In: Slutsky DJ, (ed.) Principles and Practice of Wrist Surgery. Philadelphia, PA: Saunders; 2010: 198-204
- 8 Moritomo H. The distal interosseous membrane: current concepts in wrist anatomy and biomechanics. J Hand Surg Am 2012; 37: 1501-1507
- 9 Moritomo H, Omori S. Influence of ulnar translation of the radial shaft in distal radius fracture on distal radioulnar joint instability. J Wrist Surg 2014; 3: 18-21
- 10 Ross M, Di Mascio L, Peters S et al. Defining residual radial translation of distal radius fractures: a potential cause of distal radioulnar joint instability. J Wrist Surg 2014; 3: 22-29
- 11 Noda K, Goto A, Murase T et al. Interosseous membrane of the forearm: an anatomical study of ligament attachment locations. J Hand Surg Am 2009; 34: 415-422
- 12 Moritomo H, Noda K, Goto A et al. Interosseous membrane of the forearm: length change of ligaments during forearm rotation. J Hand Surg Am 2009; 34: 685-691
- 13 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: 1626-1630
- 14 Moritomo H. The distal oblique bundle of the distal interosseous membrane of the forearm. J Wrist Surg 2013; 2: 93-94
- 15 Okada K, Moritomo H, Miyake J et al. Morphological evaluation of the distal interosseous membrane using ultrasound. Eur J Orthop Surg Traumatol 2013; [Epub ahead of print]
- 16 Gabl M, Zimmermann R, Angermann P et al. The interosseous membrane and its influence on the distal radioulnar joint. An anatomical investigation of the distal tract. J Hand Surg 1998; 23: 179-182
- 17 Rapley JH, Kearny JP, Schrayer A et al. Ulnar translation, a commonly overlooked, unrecognized deformity of distal radius fractures: techniques to correct the malalignment. Tech Hand Up Extrem Surg 2008; 12: 166-169
- 18 Koh S, Andersen CR, Buford Jr WL et al. Anatomy of the distal brachioradialis and its potential relationship to distal radius fracture. J Hand Surg 2006; 31A: 2-8
- 19 Nishiwaki M, Nakamura T, Nakao Y et al. Ulnar shortening effect on distal radioulnar joint stability: a biomechanical study. J Hand Surg 2005; 30A: 719-726
- 20 Arimitsu S, Moritomo H, Kitamura K et al. The stabilizing effect of the distal interosseous membrane on the distal radioulnar joint in ulnar shortening procedure: a biomechanical study. J Bone Joint Surg 2011; 93A: 2022-2030