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The kinematics of the normal distal radioulnar joint (DRUJ) and the stabilizing function
of various structures about the DRUJ were investigated in a study involving six fresh
frozen cadavers. Sequential division of the supporting structures was correlated with
abnormalities detected by computerized tomography (CT). The infratendinous portion
of the extensor carpi ulnaris is a major restraint against dorsal and palmar subluxation.
Division of the radioulnar ligaments and triangular fibrocartilage alone produced
only minor changes. Lateral displacement was controlled by the interosseous membrane
and the pronator quadratus. CT is a useful method of gaining objective and quantifiable
information regarding incongruity of the DRUJ. Three scans—one each in pronation,
neutral, and supination—would be optimal. The pronation scan is likely to detect palmar
subluxation, while the neutral scan is sensitive for dorsal subluxation and DRUJ diastasis.
The supination view should confirm reduction of any subluxation. An important observation
of this study was the spontaneous reduction of palmar, dorsal, and lateral displacement
in supination. This suggests that immobilization in supination may be indicated in
cases of acute DRUJ injury.
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Article info
Publication history
Accepted:
January 10,
1986
Received:
July 1,
1985
Identification
Copyright
© 1986 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
