Relative contributions of the ulnar attachments of the triangular fibrocartilage complex to the dynamic stability of the distal radioulnar joint

Jan Ragnar Haugstvedt, Richard A. Berger, Toshiyasu Nakamura, Patricia Neale, Lawrence Berglund, Kai Nan An

Research output: Contribution to journalArticle

118 Scopus citations

Abstract

Purpose: Laboratory studies evaluating the importance of the stabilizing structures of the distal radioulnar joint (DRUJ) largely have been limited to static design. Clinically, dynamic loading seems to be an important component of DRUJ instability. This study was designed to evaluate the influence of dynamic loading on the stability of the DRUJ with foveal versus styloid triangular fibrocartilage complex (TFCC) disruptions in a laboratory setting. Methods: Twelve fresh-frozen cadaveric upper-extremity specimens were tested using a dynamic simulator to study the contributions of the 2 ulnar insertions of the TFCC to the dynamic stability of the DRUJ. The specimens were tested in 3 loading conditions (no load, agonist loading, antagonist loading) in 3 different states of the TFCC (intact, foveal disruption, styloid disruption). Results: Without load no significant differences were found for the different conditions of the TFCC. Under loaded conditions the foveal insertion had a greater effect on stability than did the styloid insertion. Under agonist loading significant differences were found during supinating and pronating motions. With antagonist loading a significant difference was found only during supination. Conclusions: The study results support the clinical impression that dynamic loading is an important component of DRUJ instability and that disruption of the foveal TFCC insertion into the foveal region of the distal ulna can produce instability.

Original languageEnglish (US)
Pages (from-to)445-451
Number of pages7
JournalJournal of Hand Surgery
Volume31
Issue number3
DOIs
StatePublished - Mar 1 2006

Keywords

  • DRUJ
  • Distal radioulnar joint
  • Ligaments
  • Stability
  • Wrist joint

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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