The Function of the Distal Interosseous Membrane and its Relevance to the Stability of the Distal Radioulnar Joint: An Anatomical and Biomechanical Review

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.

Key words

distal interosseous membrane (DIOM) - distal radioulnar joint (DRUJ) - ulnar impaction syndrome

Schlüsselwörter

Distaler Anteil der Membrana interossea (DMIO) - distales Radioulnargelenk (DRUG) - Ulna-Impaktionssyndrom

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