Purpose
To assess the wrist joints of healthy volunteers in extended and loaded states versus
the unloaded state by using computed tomography (CT) to analyze the in vivo 3-dimensional movements in the distal radioulnar joint (DRUJ).
Methods
The dominant arms of 9 volunteers with healthy wrists were studied. We mounted a compression
device onto the elbows in an inverted position. A 0-kg and 7-kg load each was applied
during low-dose radiation CT imaging and a bone model was produced. We marked the
insertion sites for the 4 radioulnar ligaments stabilizing the DRUJ: palmar superficial
radioulnar ligament (PS-RUL), dorsal superficial radioulnar ligament (DS-RUL), dorsal
deep radioulnar ligament (DD-RUL), and palmar deep radioulnar ligament (PD-RUL). Using
Marai’s method, each ligament was virtualized and the length of each simulated ligament
was measured. We also computed the 3-dimensional displacement and corresponding rotation
of the distal ulna where it comes into contact with the radius in the sigmoid notch.
Results
The lengths of palmar ligaments (PS-RUL and PD-RUL) increased significantly under
loaded conditions, and although not significant, the length of dorsal ligaments (DS-RUL
and DD-RUL) tended to increase. When the wrist was loaded, the ulna rotated toward
the open palmar side.
Conclusions
The length of simulated radioulnar ligaments increased when the wrist joint was loaded
in an extended position. This kinematic movement of DRUJ separation under a loading
condition is different from physiological active movement.
Clinical relevance
The 3-dimensional kinematic analysis revealed that palmar radioulnar ligaments were
stretched during axial loading, suggesting that a tear of the palmer ligament can
result from a fall on an outstretched hand.
Key words
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Article info
Publication history
Published online: August 14, 2018
Accepted:
June 20,
2018
Received:
June 9,
2017
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2019 by the American Society for Surgery of the Hand. All rights reserved.
