Soubeyrand M, Wassermann V, Hirsch C, Oberlin C, Gagey O, Dumontier C
Bicetre University Hospital, Department of Orthopaedic Surgery, Le Kremlin-Bicetre, France.
J Hand Surg Eur Vol. 2011 Jul;36(6):447-54. doi: 10.1177/1753193410396976. Epub 2011 Mar 29.
The forearm is composed of the radial and ulnar shafts, which are linked by the interosseous membrane and intercalated between the elbow and wrist. The radius and ulna are connected by three joints, the proximal, middle, and distal radioulnar joints. The forearm ensures pronation/supination and longitudinal load transfer. The biomechanical and clinical relevance of the proximal and distal radioulnar joints is well established. In contrast, the middle radioulnar joint was considered relatively unimportant until studies published in the last decade showed that it fulfils crucial biomechanical functions and is of considerable clinical significance. We believe the conventional concept in which the forearm is viewed as part of either the elbow or the wrist is outdated and that a more relevant concept describes the forearm as a triarticular complex that functions as a full-fledged entity. In this concept, the three forearm radioulnar joints (proximal, middle, distal) work together to provide stability, mobility and load transfer. Here, we will argue for the relevance of the triarticular complex concept based on published data about forearm biomechanics and pathological conditions.
前臂由桡骨干和尺骨干组成，它们通过骨间膜相连，并介于肘部和腕部之间。桡骨和尺骨通过三个关节相连，即近端、中间和远端桡尺关节。前臂负责旋前/旋后以及纵向负荷传递。近端和远端桡尺关节的生物力学和临床相关性已得到充分证实。相比之下，直到过去十年发表的研究表明中间桡尺关节具有关键的生物力学功能且具有相当大的临床意义之前，它一直被认为相对不重要。我们认为，将前臂视为肘部或腕部一部分的传统观念已经过时，更恰当的观念是将前臂描述为一个三关节复合体，它作为一个完整的实体发挥作用。在这个概念中，前臂的三个桡尺关节（近端、中间、远端）共同协作以提供稳定性、灵活性和负荷传递。在此，我们将基于已发表的有关前臂生物力学和病理状况的数据，论证三关节复合体概念的相关性。
