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J Wrist Surg 2017; 06(02): 097-101
DOI: 10.1055/s-0036-1584545
Scientific Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Role of the Interosseous Membrane in Preventing Distal Radioulnar Gapping

Frederick W. Werner
1   Department of Orthopedic Surgery, SUNY Upstate Medical University, Syracuse, New York
,
Matthew R. LeVasseur
1   Department of Orthopedic Surgery, SUNY Upstate Medical University, Syracuse, New York
,
Brian J. Harley
1   Department of Orthopedic Surgery, SUNY Upstate Medical University, Syracuse, New York
,
Ashley Anderson
1   Department of Orthopedic Surgery, SUNY Upstate Medical University, Syracuse, New York
› Author Affiliations
Further Information

Publication History

13 May 2016

18 May 2016

Publication Date:
20 June 2016 (online)

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Abstract

Background Damage to the interosseous membrane (IOM) can alter load transmission between the radius and ulna and decrease their axial stability. Less is known about the effect of IOM sectioning on the transverse stability between the radius and ulna.

Purpose The purpose of this study was to quantify the radioulnar gapping at the distal radioulnar joint (DRUJ) during forearm rotation when the IOM was experimentally sectioned while maintaining the integrity of the distal radioulnar ligaments.

Methods In 12 fresh-frozen cadaver forearms tested in a combined wrist–forearm simulator, the increase in gap between the radius and ulna, at the level of the DRUJ, was determined during cyclic forearm rotation following IOM sectioning.

Results IOM sectioning caused a significant increase in dorsal gapping at the DRUJ by 2.1 mm in supination and 0.6 mm in pronation. It also caused an increase in palmar gapping by 1.3 mm in supination and 0.5 mm in pronation.

Conclusion This experiment has shown that the IOM has an important role in stabilizing the DRUJ, especially in supination, and that IOM sectioning caused greater loads on the palmar and dorsal radioulnar ligaments. Since DRUJ instability is primarily treated by fixing the laxity at the dorsal radioulnar ligament (DRUL) and palmar radioulnar ligament (PRUL), untreated IOM damage could permit additional injury and instability to the radioulnar ligaments or their reconstruction.

Clinical Relevance Reconstruction of a torn IOM should be considered in the presence of persistent DRUJ instability following DRUJ reconstruction.

Keywords

distal radioulnar joint - interosseous membrane - stability
 

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