TOTBİD Dergisi

TOTBİD Dergisi

2021, Cilt 20, Sayı, 4     (Sayfalar: 370-379)

Distal radioulnar joint and ulnocarpal complex anatomy

Murat İpteç 1, Bilge Özkan 1, Mehmet Eren 1

1 Başakşehir Çam ve Sakura Şehir Hastanesi, El Cerrahisi Kliniği, İstanbul

DOI: 10.14292/totbid.dergisi.2021.62
Görüntüleme: 1111
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İndirme : 1166

Forearm joint; it is basically a three-part joint with the distal radioulnar joint (DRUJ), the proximal radioulnar joint and the interosseous membrane (IOM). DRUJ; it is a trochoid type joint formed by the fit of a cylindrical part of a bone (ulnar head) to a concavity (sigmoid notch) corresponding to this cylindrical part on another bone. DRUJ is vital for the optimal function of the wrist during forearm pronosupination. Its stabilization is provided by both bone and soft tissues. However, stability is highly dependent on soft tissue stabilizers. The resulting movement is rotation or rotational movements. This rotational movement, also known as pronation and supination, is the movement that occurs around a longitudinal axis that extends from the center of the radial head of the forearm to the fovea of the ulnar head. In DRUJ, movement occurs in 3 planes: 1) Longitudinal rotation in the forearm axis, 2) dorsal-palmar translation and 3) proximal-distal translation. There are 3 important anatomical indicators commonly used to evaluate DRUJ. 1) Ulnar variance describes the length relationship between distal ulna and radius. 2) In the frontal plane, the DRUJ sits inclined 20° to the anatomical long axis of the forearm but parallel to the radioulnar rotation axis. This relationship allows an equal transfer of force on the DRUJ throughout the pronosupination arc. 3) In the sagittal plane, the radius exhibits a posterior bend that allows better insertion of the ulna in the last pronation interval. Triangular fibrocartilage complex (TFCC), which absorbs compressive loads transmitted from the ulnar carpus to the ulna; It can be defined as a complex 3D structure with important mechanical properties of control and load transfer. TFCC is considered as the primary stabilizer of DRUJ as a whole. The interosseous membrane (IOM) is a large connective structure that connects the radius and ulna along almost their entire length. The main function of IOM is to stabilize the relationship between radius and ulna along the pronosupination arc.

Anahtar Kelimeler : distal radioulnar joint (DRUJ); sigmoid notch; pronosupination; triangular fibrocartilage complex (TFCC)