J Wrist Surg 2017; 06(02): 088-096
DOI: 10.1055/s-0037-1601367
Special Review: Biomechanics of DRUJ Instability
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

A Biomechanical Perspective on Distal Radioulnar Joint Instability

Shohei Omokawa
1   Department of Hand Surgery, Nara Medical University, Kashihara, Nara, Japan
,
Akio Iida
2   Department of Orthopedic Surgery, Nara Medical University, Kashihara, Nara, Japan
,
Kenji Kawamura
2   Department of Orthopedic Surgery, Nara Medical University, Kashihara, Nara, Japan
,
Yasuaki Nakanishi
2   Department of Orthopedic Surgery, Nara Medical University, Kashihara, Nara, Japan
,
Takamasa Shimizu
2   Department of Orthopedic Surgery, Nara Medical University, Kashihara, Nara, Japan
,
Tsutomu Kira
2   Department of Orthopedic Surgery, Nara Medical University, Kashihara, Nara, Japan
,
Tadanobu Onishi
2   Department of Orthopedic Surgery, Nara Medical University, Kashihara, Nara, Japan
,
Naoki Hayami
2   Department of Orthopedic Surgery, Nara Medical University, Kashihara, Nara, Japan
,
Yasuhito Tanaka
2   Department of Orthopedic Surgery, Nara Medical University, Kashihara, Nara, Japan
› Author Affiliations
Further Information

Publication History

28 December 2016

27 February 2017

Publication Date:
22 March 2017 (online)

Abstract

Background The purpose of this article was to review the anatomy, kinematics of the distal radioulnar joint (DRUJ), and to discuss definition, classification, and diagnosis of DRUJ instability.

Methods A biomechanical perspective on physical examination of DRUJ ballottement test was documented. Physiological dynamic DRUJ translation and differences of the translation following sequential ligament sectioning and changes in different forearm and wrist positions were demonstrated. The clinical significance of each ligament's contribution to joint stability in specific wrist positions was addressed.

Conclusion Each ligament stabilizing the DRUJ contributed to joint stability depending on the direction (palmer or dorsal) and different positions of the wrist and forearm. DRUJ ballottement test in each wrist and forearm position may detect tears of specific ligament stabilizing the DRUJ.