Pathomechanisms of ulnar ligament lesions of the wrist in a cadaveric distal radius fracture model
2011 (English)In: Acta Orthopaedica, ISSN 1745-3674, E-ISSN 1745-3682, Vol. 82, no 3, 360-364 p.Article in journal (Refereed) Published
Background and purpose: Mechanisms of injury to ulnar sided ligaments, stabilizing the distal radioulnar joint and the ulna to the carpus, associated with dorsally displaced distal radius fractures are poorly described. We investigated the injury patterns in a human cadaver fracture model.
Methods: Fresh frozen human cadaver arms were used. A dorsal open wedge osteotomy was made in the distal radius. In 8 specimens pressure was applied to the palm with the wrist in dorsiflexion and ulnar sided stabilizing structures subsequently severed. Dorsal angulation was measured on digitized radiographs. In 8 more specimens the triangular fibrocartilage complex was forced into rupture by axially loading the forearm with the wrist in dorsiflexion. The ulnar side was dissected and injuries were recorded.
Results: Intact ulnar soft tissues limited the dorsal angulation of the distal radius fragment to a median of 32o (16-34o). A combination of bending and shearing of the distal radius fragment was needed to create TFCC injuries. Both palmar and dorsal injuries were observed simultaneously in 6/8 specimens.
Interpretation: A TFCC injury can be expected when dorsal angulation of a distal radius fracture exceeds 32o. The extensor carpi ulnaris subsheath may be a functionally integral part of the TFCC. Both dorsal and palmar structures can tear simultaneously. These findings may have implications for reconstruction of ulnar sided soft tissue injuries.
Place, publisher, year, edition, pages
Informa Healthcare , 2011. Vol. 82, no 3, 360-364 p.
Distal radius fracture, Triangular fibrocartilage complex, Pathomechanisms, Wrist injury
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:liu:diva-67926DOI: 10.3109/17453674.2011.579517ISI: 000291060000017OAI: oai:DiVA.org:liu-67926DiVA: diva2:414250