Download PDF
J Wrist Surg 2021; 10(03): 208-215
DOI: 10.1055/s-0040-1722334
Scientific Article

Biomechanics of the Distal Radioulnar Joint During In Vivo Forearm Pronosupination

Bardiya Akhbari 
1   Center for Biomedical Engineering, Brown University, Providence, Rhode Island
,
Kalpit N. Shah 
2   Department of Orthopedics, The Warren Alpert Medical School of Brown University and Rhode Island Hospital, Providence, Rhode Island
,
Amy M. Morton 
2   Department of Orthopedics, The Warren Alpert Medical School of Brown University and Rhode Island Hospital, Providence, Rhode Island
,
Douglas C. Moore 
2   Department of Orthopedics, The Warren Alpert Medical School of Brown University and Rhode Island Hospital, Providence, Rhode Island
,
Arnold-Peter C. Weiss 
2   Department of Orthopedics, The Warren Alpert Medical School of Brown University and Rhode Island Hospital, Providence, Rhode Island
3   Division of Hand, Upper Extremity & Microvascular Surgery, Department of Orthopaedics, The Warren Alpert Medical School of Brown University and Rhode Island Hospital, Providence, Rhode Island
,
Scott W. Wolfe 
4   Hand and Upper Extremity Center, Hospital for Special Surgery, New York, New York
5   Department of Orthopaedic Surgery, Weill Medical College of Cornell University, New York, New York
,
Joseph J. Crisco 
1   Center for Biomedical Engineering, Brown University, Providence, Rhode Island
2   Department of Orthopedics, The Warren Alpert Medical School of Brown University and Rhode Island Hospital, Providence, Rhode Island
› Author Affiliations Funding J.J.C reports grants from National Institute of General Medical Sciences (P30GM122732), and from the American Foundation for Surgery of the Hand (AFSH) during the conduct of the study.
› Further Information
   Permissions and Reprints

Abstract

Background Ulnar variance (UV) and center of rotation (COR) location at the level of the distal radioulnar joint (DRUJ) change with forearm rotation. Nevertheless, these parameters have not been assessed dynamically during active in vivo pronosupination. This assessment could help us to improve our diagnosis and treatment strategies.

Questions/purposes We sought to (1) mathematically model the UV change, and (2) determine the dynamic COR's location during active pronosupination.

Methods We used biplanar videoradiography to study DRUJ during in vivo pronation and supination in nine healthy subjects. UV was defined as the proximal-distal distance of ulnar fovea with respect to the radial sigmoid notch, and COR was calculated using helical axis of motion parameters. The continuous change of UV was evaluated using a generalized linear regression model.

Results A second-degree polynomial with R 2 of 0.85 was able to model the UV changes. Maximum negative UV occurred at 38.0 degrees supination and maximum positive UV occurred at maximum pronation. At maximum pronation, the COR was located 0.5 ± 1.8 mm ulnarly and 0.6 ± 0.8 mm volarly from the center of the ulnar fovea, while at maximum supination, the COR was located 0.2 ± 0.6 mm radially and 2.0 ± 0.5 mm volarly.

Conclusion Changes in UV and volar translation of the COR are nonlinear at the DRUJ during pronosupination.

Clinical Relevance Understanding the dynamic nature of UV as a function of pronosupination can help guide accurate evaluation and treatment of wrist pathology where the UV is an important consideration. The dynamic behavior of COR might be useful in designing DRUJ replacement implants to match the anatomical motion.

Keywords

radioulnar joint - kinematics - ulnar variance - DRUJ - center of rotation


Publication History

Received: 28 August 2020

Accepted: 12 November 2020

Article published online:
04 February 2021

© 2021. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Linscheid RL. Biomechanics of the distal radioulnar joint. Clin Orthop Relat Res 1992; (275) 46-55
    PubMedGoogle Scholar
  • 2 Shaaban H, Giakas G, Bolton M, Williams R, Scheker LR, Lees VC. The distal radioulnar joint as a load-bearing mechanism—a biomechanical study. J Hand Surg Am 2004; 29 (01) 85-95
    CrossrefPubMedGoogle Scholar
  • 3 Epner RA, Bowers WH, Guilford WB. Ulnar variance—the effect of wrist positioning and roentgen filming technique. J Hand Surg Am 1982; 7 (03) 298-305
    CrossrefPubMedGoogle Scholar
  • 4 Friedman SL, Palmer AK. The ulnar impaction syndrome. Hand Clin 1991; 7 (02) 295-310
    CrossrefPubMedGoogle Scholar
  • 5 Laino DK, Petchprapa CN, Lee SK. Ulnar variance: correlation of plain radiographs, computed tomography, and magnetic resonance imaging with anatomic dissection. J Hand Surg Am 2012; 37 (01) 90-97
    CrossrefPubMedGoogle Scholar
  • 6 Palmer AK, Werner FW. The triangular fibrocartilage complex of the wrist—anatomy and function. J Hand Surg Am 1981; 6 (02) 153-162
    CrossrefPubMedGoogle Scholar
  • 7 Sammer DM, Rizzo M. Ulnar impaction. Hand Clin 2010; 26 (04) 549-557
    CrossrefPubMedGoogle Scholar
  • 8 Palmer AK, Werner FW. Biomechanics of the distal radioulnar joint. Clin Orthop Relat Res 1984; (187) 26-35
    PubMedGoogle Scholar
  • 9 Calcagni M, Giesen T. Distal radioulnar joint arthroplasty with implants: a systematic review. EFORT Open Rev 2017; 1 (05) 191-196
    CrossrefPubMedGoogle Scholar
  • 10 Herzberg G, Burnier M, Marc A, Izem Y. Primary wrist hemiarthroplasty for irreparable distal radius fracture in the independent elderly. J Wrist Surg 2015; 4 (03) 156-163
    Article in Thieme ConnectPubMedGoogle Scholar
  • 11 Mikkelsen SS, Lindblad BE, Larsen ER, Sommer J. Sauvé-Kapandji operation for disorders of the distal radioulnar joint after Colles' fracture. Good results in 12 patients followed for 1.5-4 years. Acta Orthop Scand 1997; 68 (01) 64-66
    CrossrefPubMedGoogle Scholar
  • 12 Degreef I, De Smet L. The Scheker distal radioulnar joint arthroplasty to unravel a virtually unsolvable problem. Acta Orthop Belg 2013; 79 (02) 141-145
    PubMedGoogle Scholar
  • 13 Strigel RM, Richardson ML. Distal radioulnar joint arthroplasty with a Scheker prosthesis. Radiol Case Rep 2015; 1 (02) 66-68
    CrossrefPubMedGoogle Scholar
  • 14 Tulipan DJ, Eaton RG, Eberhart RE. The Darrach procedure defended: technique redefined and long-term follow-up. J Hand Surg Am 1991; 16 (03) 438-444
    CrossrefPubMedGoogle Scholar
  • 15 Banks SA, Hodge WA. Implant design affects knee arthroplasty kinematics during stair-stepping. Clin Orthop Relat Res 2004; (426) 187-193
    CrossrefPubMedGoogle Scholar
  • 16 Gregory TM, Sankey A, Augereau B. et al. Accuracy of glenoid component placement in total shoulder arthroplasty and its effect on clinical and radiological outcome in a retrospective, longitudinal, monocentric open study. PLoS One 2013; 8 (10) e75791
    CrossrefPubMedGoogle Scholar
  • 17 Galbusera F, Anasetti F, Bellini CM, Costa F, Fornari M. The influence of the axial, antero-posterior and lateral positions of the center of rotation of a ball-and-socket disc prosthesis on the cervical spine biomechanics. Clin Biomech (Bristol, Avon) 2010; 25 (05) 397-401
    CrossrefPubMedGoogle Scholar
  • 18 Lecerf G, Fessy MH, Philippot R. et al. Femoral offset: anatomical concept, definition, assessment, implications for preoperative templating and hip arthroplasty. Orthop Traumatol Surg Res 2009; 95 (03) 210-219
    CrossrefPubMedGoogle Scholar
  • 19 Matsuki KO, Matsuki K, Mu S. et al. In vivo 3D kinematics of normal forearms: analysis of dynamic forearm rotation. Clin Biomech (Bristol, Avon) 2010; 25 (10) 979-983
    CrossrefPubMedGoogle Scholar
  • 20 Tay SC, van Riet R, Kazunari T, Amrami KK, An K-N, Berger RA. In-vivo kinematic analysis of forearm rotation using helical axis analysis. Clin Biomech (Bristol, Avon) 2010; 25 (07) 655-659
    CrossrefPubMedGoogle Scholar
  • 21 Fu E, Li G, Souer JS. et al. Elbow position affects distal radioulnar joint kinematics. J Hand Surg Am 2009; 34 (07) 1261-1268
    CrossrefPubMedGoogle Scholar
  • 22 Bellevue KD, Thayer MK, Pouliot M, Huang JI, Hanel D. Complications of aptis DRUJ arthroplasty. J Hand Surg Am 2017; 42 (09) S14-S15
    CrossrefPubMedGoogle Scholar
  • 23 Jung JM, Baek GH, Kim JH, Lee YH, Chung MS. Changes in ulnar variance in relation to forearm rotation and grip. J Bone Joint Surg Br 2001; 83 (07) 1029-1033
    CrossrefPubMedGoogle Scholar
  • 24 Yeh GL, Beredjiklian PK, Katz MA, Steinberg DR, Bozentka DJ. Effects of forearm rotation on the clinical evaluation of ulnar variance. J Hand Surg Am 2001; 26 (06) 1042-1046
    CrossrefPubMedGoogle Scholar
  • 25 Baeyens J-P, Van Glabbeek F, Goossens M, Gielen J, Van Roy P, Clarys J-P. In vivo 3D arthrokinematics of the proximal and distal radioulnar joints during active pronation and supination. Clin Biomech (Bristol, Avon) 2006; 21 (Suppl. 01) S9-S12
    CrossrefPubMedGoogle Scholar
  • 26 Abe S, Otake Y, Tennma Y. et al. Analysis of forearm rotational motion using biplane fluoroscopic intensity-based 2D-3D matching. J Biomech 2019; 89: 128-133
    CrossrefPubMedGoogle Scholar
  • 27 Akhbari B, Morton A, Moore D, Weiss AC, Wolfe SW, Crisco J. Kinematic accuracy in tracking total wrist arthroplasty with biplane videoradiography using a CT-generated model. J Biomech Eng 2019; 141 (04) 0445031-0445037
    CrossrefPubMedGoogle Scholar
  • 28 Akhbari B, Morton AM, Moore DC, Weiss AC, Wolfe SW, Crisco JJ. Accuracy of biplane videoradiography for quantifying dynamic wrist kinematics. J Biomech 2019; 92: 120-125
    CrossrefPubMedGoogle Scholar
  • 29 Anderst W, Zauel R, Bishop J, Demps E, Tashman S. Validation of three-dimensional model-based tibio-femoral tracking during running. Med Eng Phys 2009; 31 (01) 10-16
    CrossrefPubMedGoogle Scholar
  • 30 Bey MJ, Kline SK, Tashman S, Zauel R. Accuracy of biplane X-ray imaging combined with model-based tracking for measuring in-vivo patellofemoral joint motion. J Orthop Surg Res 2008; 3: 38
    CrossrefPubMedGoogle Scholar
  • 31 Bey MJ, Zauel R, Brock SK, Tashman S. Validation of a new model-based tracking technique for measuring three-dimensional, in vivo glenohumeral joint kinematics. J Biomech Eng 2006; 128 (04) 604-609
    CrossrefPubMedGoogle Scholar
  • 32 Miranda DL, Schwartz JB, Loomis AC, Brainerd EL, Fleming BC, Crisco JJ. Static and dynamic error of a biplanar videoradiography system using marker-based and markerless tracking techniques. J Biomech Eng 2011; 133 (12) 121002
    CrossrefPubMedGoogle Scholar
  • 33 Tashman S, Anderst W. In-vivo measurement of dynamic joint motion using high speed biplane radiography and CT: application to canine ACL deficiency. J Biomech Eng 2003; 125 (02) 238-245
    CrossrefPubMedGoogle Scholar
  • 34 Akhbari B, Morton AM, Shah KN. et al. Proximal-distal shift of the center of rotation in a total wrist arthroplasty is more than twice of the healthy wrist. J Orthop Res 2020; 38 (07) 1575-1586
    CrossrefPubMedGoogle Scholar
  • 35 Moore DC, Hogan KA, Crisco III JJ, Akelman E, Dasilva MF, Weiss A-PC. Three-dimensional in vivo kinematics of the distal radioulnar joint in malunited distal radius fractures. J Hand Surg Am 2002; 27 (02) 233-242
    CrossrefPubMedGoogle Scholar
  • 36 Knörlein BJ, Baier DB, Gatesy SM, Laurence-Chasen JD, Brainerd EL. Validation of XMALab software for marker-based XROMM. J Exp Biol 2016; 219 (Pt 23): 3701-3711
    PubMedGoogle Scholar
  • 37 Miranda DL, Rainbow MJ, Crisco JJ, Fleming BC. Kinematic differences between optical motion capture and biplanar videoradiography during a jump-cut maneuver. J Biomech 2013; 46 (03) 567-573
    CrossrefPubMedGoogle Scholar
  • 38 Broga D. Ionizing radiation exposure of the population of the United States. Med Phys 2009; 36 (11) 5375-5375
    CrossrefPubMedGoogle Scholar
  • 39 Akhbari B, Moore DC, Laidlaw DH. et al. Predicting carpal bone kinematics using an expanded digital database of wrist carpal bone anatomy and kinematics. J Orthop Res 2019; 37 (12) 2661-2670
    CrossrefPubMedGoogle Scholar
  • 40 Crisco JJ, Coburn JC, Moore DC, Akelman E, Weiss A-PC, Wolfe SW. In vivo radiocarpal kinematics and the dart thrower's motion. J Bone Joint Surg Am 2005; 87 (12) 2729-2740
    CrossrefPubMedGoogle Scholar
  • 41 Kennedy J, Eberhart R. Particle swarm optimization. Paper presented at: Proceedings of the IEEE International Conference on Neural Networks. Piscataway, NJ: IEEE Press; 1995: 1942-1948
    Google Scholar
  • 42 Panjabi M, White III AA. A mathematical approach for three-dimensional analysis of the mechanics of the spine. J Biomech 1971; 4 (03) 203-211
    CrossrefPubMedGoogle Scholar
  • 43 Tay SC, Berger RA, Tomita K, Tan ET, Amrami KK, An K-N. In vivo three-dimensional displacement of the distal radioulnar joint during resisted forearm rotation. J Hand Surg Am 2007; 32 (04) 450-458
    CrossrefPubMedGoogle Scholar
  • 44 Gilula LA, Mann FA, Dobyns JH, Yin Y. Wrist terminology as defined by the International Wrist Investigators' Workshop (IWIW). J Bone Joint Surg 2002; 84: 1-66
    CrossrefPubMedGoogle Scholar
  • 45 Kachooei AR, Chase SM, Jupiter JB. Outcome assessment after aptis distal radioulnar joint (DRUJ) implant arthroplasty. Arch Bone Jt Surg 2014; 2 (03) 180-184
    PubMedGoogle Scholar
  • 46 Tolat AR, Stanley JK, Trail IA. A cadaveric study of the anatomy and stability of the distal radioulnar joint in the coronal and transverse planes. J Hand Surg [Br] 1996; 21 (05) 587-594
    CrossrefPubMedGoogle Scholar