Kataoka T, Moritomo H, Omokawa S, Iida A, Wada T, Aoki M
Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
J Hand Surg Eur Vol. 2013 Jun;38(5):515-22. doi: 10.1177/1753193412461743. Epub 2012 Oct 3.
We developed a new triangular fibrocartilage complex reconstruction technique for distal radioulnar joint instability in which the palmar portion of the triangular fibrocartilage complex was predominantly reconstructed, and evaluated whether such reconstruction can restore stability of the distal radioulnar joint in seven fresh cadaver upper extremities. Distal radioulnar joint instability was induced by cutting all soft-tissue stabilizers around the distal ulna. Using a palmar approach, a palmaris longus tendon graft was sutured to the remnant of the palmar radioulnar and ulnocarpal ligaments. The graft was then passed through a bone tunnel created at the fovea and was sutured. Loads were applied to the radius, and dorsopalmar displacements of the radius relative to the ulna were measured using an electromagnetic tracking device in neutral rotation, 60° supination and 60° pronation. We compared the dorsopalmar displacements before sectioning, before reconstruction and after reconstruction. Dorsopalmar instability produced by sectioning significantly improved in all forearm positions after reconstruction.
我们开发了一种用于桡尺远侧关节不稳定的新型三角纤维软骨复合体重建技术，该技术主要重建三角纤维软骨复合体的掌侧部分，并在七具新鲜尸体上肢中评估这种重建是否能恢复桡尺远侧关节的稳定性。通过切断尺骨远端周围的所有软组织稳定结构来诱发桡尺远侧关节不稳定。采用掌侧入路，将掌长肌腱移植物缝合至掌侧桡尺韧带和尺腕韧带的残余部分。然后将移植物穿过在尺骨凹处创建的骨隧道并进行缝合。对桡骨施加负荷，并使用电磁跟踪装置在中立旋转、60°旋后和60°旋前时测量桡骨相对于尺骨的掌背侧位移。我们比较了切断前、重建前和重建后的掌背侧位移。重建后，在所有前臂位置，切断所产生的掌背侧不稳定均得到显著改善。
