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. 2014 Feb;3(1):18-21.
doi: 10.1055/s-0033-1364093.

Influence of ulnar translation of the radial shaft in distal radius fracture on distal radioulnar joint instability

Hisao Moritomo  1 , Shinsuke Omori  2
Affiliations

Influence of ulnar translation of the radial shaft in distal radius fracture on distal radioulnar joint instability

Hisao Moritomo et al. J Wrist Surg. 2014 Feb.

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.

Keywords: distal oblique bundle; distal radioulnar joint instability; distal radius fracture; interosseous membrane; translation.

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Conflict of interest statement

Conflict of Interest None

Figures

Fig. 1
Fig. 1
Three-dimensional computed tomographic images of a common distal radius fracture with TFCC and the extensor carpi ulnaris tendon sheath rupture (Orbay's Type B fracture) demonstrating ulnar translation deformity of the radial shaft and detensioning of the distal interosseous membrane (DIOM). The radial attachment of DIOM is located at the dorsal region of the medial wall of the radius at which the deep portion of the pronator quadratus muscle inserts (*). (a) Dorsal and (b) palmar views of the right wrist.
Fig. 2
Fig. 2
Three conditions of soft tissue stabilizers of DRUJ. (a) Intact TFCC and DIOM. (b) Complete sectioning of TFCC with intact DIOM. (c) Additional 5-mm ulnar translation of the radial shaft at the level of the proximal margin of the sigmoid notch using an external fixator.
Fig. 3
Fig. 3
(a) The distal oblique bundle (DOB), the thickest fiber of the DIOM, is stretched between the proximal margin of the dorsal rim of the sigmoid notch and the most radial aspect of the ulnar shaft 4–5 cm proximal to the distal end of the ulna. (b) In the axial view, DOB passes from the dorsoradial side to the ulnopalmar side.
See this image and copyright information in PMC

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