J Hand Microsurg 2009; 01(02): 92-99
DOI: 10.1007/s12593-009-0022-7
Review Article
Thieme Medical and Scientific Publishers Private Ltd.

The functional anatomy of forearm rotation

Vivien C. Lees

Subject Editor:
Further Information

Publication History

14 June 2009

01 September 2009

Publication Date:
05 September 2016 (online)

Abstract

The elbow, forearm and wrist act as a unified structure to provide a stable, strong and highly mobile strut for positioning the hand in space and for conducting load-bearing tasks. An understanding of the relevant anatomy and biomechanics is important for the surgeon assessing and treating disorders of forearm function. This paper is concerned with illuminating the principles and concepts governing forearm rotation and load-bearing functions.

 
  • References

  • 1 Weiss APC, Hastings H. The anatomy of the proximal radioulnar joint. J Shoulder Elbow Surg 1992; 193-199
  • 2 Grey’s Anatomy 39th ed Section 5. Chapter 53. Churchill Livingstone. Edinburgh: Elsevier; 2005. pp 901-909
  • 3 af Ekenstam F, Hagert CG. Anatomical studies on the geometry and stability of the distal radio ulnar joint. Scand J Plast Reconstr Surg 1985; 19: 17-25
  • 4 Tolat AR, Stanley JK, Trail IA. Cadaveric study of the anatomy and stability of the distal radioulnar joint in the coronal and transverse planes. J Hand Surg 1996; 21B: 587-594
  • 5 Palmer AK, Werner FW. The triangular fibrocarti-lage complex of the wrist - anatomy and function. J Hand Surg 1981; 6A: 153-162
  • 6 Nakamura T, Yabe Y, Horiuchi Y. Functional anatomy of the triangular fibrocartilage complex. J Hand Surg 1996; 21B: 581-586
  • 7 Acosta R, Hnat W, Scheker LR. Distal radioulnar ligament motion during supination and pronation. J Hand Surg 1993; 18B: 502-505
  • 8 Ishii S, Palmer AK, Werner FW et al An anatomic study of the ligamentous structure of the triangular fibro-cartilage complex. J Hand Surg 1998; 23A: 977-985
  • 9 Kleinman WB. Stability of the distal radioulnar joint: biomechanics pathophysiology. Physical diagnosis, and restoration of function what we have learned in 25 years. J Hand Surg 2007; 32A: 1086-1106
  • 10 Xu J, Tang JB. In vivo changes in lengths of the ligaments stabilizing the distal radioulnar joint. J Hand Surg 2009; 34A: 40-45
  • 11 Noda K, Goro A, Murase T et al Interosseous membrane of the forearm: An anatomical study of ligament attachment locations. J Hand Surg 2009; 34A: 415-422
  • 12 Palmer AK, Werner FW. Biomechanics of the distal radioulnar joint. Clin Orthop 1984; 187: 26-35
  • 13 Linscheid RL. Biomechanics of the distal radioulnar joint. Clin Orthop Rel Res 1992; 275: 46-55
  • 14 Kihara H, Short WH, Werner FW et al The stabilizing mechanism of the distal radioulnar joint during pronation and supination. J Hand Surg 1995; 20A: 930-936
  • 15 Shaaban H, Pereira C, Williams R et al The effect of elbow position on the range of supination and pronation of the forearm. J Hand Surg 2008; 33E (1) 3-8
  • 16 Russell CJH, Bush JA, Russell GWP et al Dynamic skin tension in the forearm: Effects of pronation and supination. J Hand Surg 2009; 34A: 423-431
  • 17 Kalson N, Malone P, Redvers-Chubb K et al Incidence of ulnar neuropathy in patients with distal radioulnar joint dysfunction. Poster. Combined meeting BSSH/ASSH. 2009. London:
  • 18 Hagert E, Garcia-Elias M, Forsgren S et al Immu-nohisotchemical analysis of wrist ligament innervation in relation to their structural composition. J Hand Surg 2007; 32A: 30-36
  • 19 af Ekenstam FW, Palmer AK, Glisson RR. The load on the radius and ulna in different positions of the wrist and forearm. A cadaver study. Acta Orthop Scand 1984; 55: 363-365
  • 20 Birkbeck DP, Failla JM, Hoshaw SJ et al The interosseous membrane affects load distribution in the forearm. J Hand Surg 1997; 22A: 975-980
  • 21 Werner FW, Glisson RR, Murphy DJ et al Force transmission through the distal radioulnar carpal joint: Effect of ulnar lengthening and shortening. Handchir Mik-rochir Plast Chirug 1986; 18: 304-308
  • 22 Lees VC, Scheker LR. The radiological demonstration of dynamic ulnar impingement. J Hand Surg 1997; 22B: 448-450
  • 23 Shaaban H, Giakis G, Bolton M et al The distal radioulnar joint as a load-bearing mechanism - a biomechanical study. J Hand Surg 2004; 29A (1) 85-90
  • 24 Shaaban H, Giakis G, Bolton M et al The loadbearing characteristics of the forearm: Pattern of axial and bending force transmitted through ulna and radius. J Hand Surg 2006; 31B: 274-279
  • 25 Shaaban H, Giakis G, Bolton M et al Pattern of contact area inside the DRUJ and the effect of injury of the distal radioulnar ligaments. Clin Biomechanics 2007; 22: 313-318
  • 26 Chandler JW, Stabile KJ, Pfaeffle HJ et al Anatomic parameters for planning of interosseous ligament reconstruction using computer-assisted techniques. J Hand Surg 2003; 28A: 111-116
  • 27 Pfaeffle HJ, Stabile KJ, Li ZM et al Reconstruction of the interosseous ligament restores normal forearm compressive load transfer in cadavers. J Hand Surg 2005; 30A: 319-325
  • 28 Bowers WH. The distal radioulnar joint. in Green’s Operative Hand Surgery. 1998. Churchill Livingstone; New York: 4th edn, pp 1011-1015
  • 29 Scheker LR, Belliappa PP, Acosta R et al Reconstruction of the dorsal ligament of the triangular fibrocarti-lage complex. J Hand Surg 1994; 19B: 310-318
  • 30 Adams BD, Berger RA. An anatomic reconstruction of the distal radioulnar ligaments for posttraumatic distal radioulnar joint instability. J Hand Surg 2002; 27A: 243-251
  • 31 Hagert CG. Distal radius fracture and the distal radioulnar joint- Anatomical considerations. Hand Chir. Mikrochir. Plast. Chir 1994; 22-26
  • 32 Lees VC, Scheker LR. Load distributing function of the distal radioulnar joint - biomechanics and total replacement arthroplasty. Proceedings 10th IFSSH Congress. 2007. Sydney, Medimond, Bologna, Italy:
  • 33 Scheker LR, Severo A. Ulnar shortening for the treatment of early post-traumatic osteoarthritis at the distal radioulnar joint. J Hand Surg 2001; 26B: 41-44
  • 34 Laurentin-Perez LA, Goodwin AN, Babb BA et al A study of functional outcome following implantation of a total distal radioulnar joint prosthesis. J Hand Surg 2008; 33E: 18-28
  • 35 Garcia-Elias M. Eclypse: partial ulnar head replacement for the isolated distal radio-ulnar joint arthrosis. Techniques Hand Upper Extrem Surg 2007; 11: 121-128
  • 36 Herbert TJ, van Schoonhoven J. Ulnar head replacement. Tech Hand Upper Extrem Surg 2007; 11: 98-108