Moritomo Hisao, Noda Kazuo, Goto Akira, Murase Tsuyoshi, Yoshikawa Hideki, Sugamoto Kazuomi
Department of Orthopaedic Surgery, Osaka University, Suita, Osaka, Japan.
J Hand Surg Am. 2009 Apr;34(4):685-91. doi: 10.1016/j.jhsa.2009.01.015.
An earlier anatomic study described five ligamentous components in the interosseous membrane of the forearm (central band, accessory band, distal oblique bundle, proximal oblique cord, and dorsal oblique accessory cord) and provided their precise location of attachment. In the present study, we investigated in vivo length changes of these five ligaments during forearm rotation to understand the function of each ligament.
We acquired computed tomographies of nine forearms from seven healthy volunteers for 3 rotation positions: maximum pronation, neutral position, and maximum supination. We created 3-dimensional models of the radius, ulna, and the 5 ligaments by combining osseous images and anatomic data of ligament attachment. We calculated 3-dimensional ligament lengths between attachments during forearm rotation using a markerless bone registration technique. We also examined relationships between the axis of forearm rotation and each ligament.
The distal 3 ligaments (central band, accessory band, and distal oblique bundle) had little change in length during forearm rotation, with their ulnar attachments located almost on the axis of forearm rotation. The 2 proximal ligaments (proximal oblique cord and dorsal oblique accessory cord) changed substantially in length, with their attachments out of the course of the axis.
The distal 3 ligaments of the interosseous membrane are essentially isometric stabilizers of the forearm. The distal oblique bundle in the distal membranous portion may stabilize the distal radioulnar joint in 40% of human subjects who have this ligament.
一项早期的解剖学研究描述了前臂骨间膜中的五个韧带成分（中央束、副束、远侧斜束、近侧斜索和背侧副斜索），并给出了它们精确的附着位置。在本研究中，我们调查了这五条韧带在前臂旋转过程中的体内长度变化，以了解每条韧带的功能。
我们获取了7名健康志愿者的9条前臂在3个旋转位置（最大旋前、中立位和最大旋后）的计算机断层扫描图像。通过结合骨骼图像和韧带附着的解剖学数据，我们创建了桡骨、尺骨和这5条韧带的三维模型。我们使用无标记骨配准技术计算了前臂旋转过程中韧带附着点之间的三维长度。我们还研究了前臂旋转轴与每条韧带之间的关系。
远侧的3条韧带（中央束、副束和远侧斜束）在前臂旋转过程中长度变化很小，它们在尺骨上的附着点几乎位于前臂旋转轴上。近侧的2条韧带（近侧斜索和背侧副斜索）长度变化很大，它们的附着点不在旋转轴的路径上。
骨间膜的远侧3条韧带本质上是前臂的等长稳定器。在有该韧带的40%的人群中，可以推测远侧膜部的远侧斜束可能稳定远侧桡尺关节。
