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).
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.
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.
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.
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.
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Published online: August 14, 2018
Accepted: June 20, 2018
Received: June 9, 2017
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
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