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. 2016 Aug;5(3):179-83.
doi: 10.1055/s-0036-1584547. Epub 2016 Jun 20.

Suture-Button Reconstruction of the Interosseous Membrane

Clifton G Meals  1 , Christopher L Forthman  1 , Keith A Segalman  1
Affiliations

Suture-Button Reconstruction of the Interosseous Membrane

Clifton G Meals et al. J Wrist Surg. 2016 Aug.

Abstract

Background: Reconstruction of the interosseous membrane (IOM) may play a role in the treatment of acute and chronic longitudinal forearm instability. Several reconstruction techniques have been proposed. Suture-button reconstruction is attractive because it obviates donor site morbidity and is relatively easy to perform. How this method compares to its alternatives, however, is unknown.

Materials and methods: We review literature describing reconstruction of the forearm axis. We describe how we perform suture-button reconstruction of the IOM, summarize our previously published biomechanical data on the subject, and offer a case report.

Description of technique: A suture-button is implanted so as to approximate the course of the interosseous ligament. This may be accomplished percutaneously, or when grafting is desired, through an open approach.

Results: Data informing the choice of one reconstruction technique over another consist mostly of biomechanical studies and a small number of case reports.

Conclusions: Suture-button reconstruction of the IOM may encourage anatomic healing of acute forearm axis injuries especially as an adjunct to radial head replacement or repair. Chronic injuries may benefit from a combination suture-button graft construct and ulnar shortening osteotomy.

Keywords: Suture-button; forearm; instability; interosseous ligament; interosseous membrane.

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Conflict of interest statement

Conflict of Interest None.

Figures

Fig. 1
Fig. 1
Interosseous membrane rupture has led to distal migration of the ulna and ulnocarpal impaction, (A) posteroanterior view; (B) lateral view.
Fig. 2
Fig. 2
The position of the graft (approximating the position of the IOL) is depicted between a point two-third the length of the ulna from the ulnar styloid and three-fifth the length of the radius from the radial styloid.
Fig. 3
Fig. 3
Lateral (A) and posteroanterior (B) postoperative radiographs demonstrating an ulnar shortening osteotomy and suture button reconstruction of the interosseous membrane are shown. Suture anchors were placed around the elbow in a previous procedure.
See this image and copyright information in PMC

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