Moritomo H
Osaka Yukioka College of Health Science, Yukioka Hospital Hand Center, Osaka-shi, Japan.
Handchir Mikrochir Plast Chir. 2015 Oct;47(5):277-80. doi: 10.1055/s-0035-1545348. Epub 2015 May 4.
The purpose of this article is to review functional anatomy and biomechanics of the distal interosseous membrane (DIOM) and its relevance to the stability of the distal radioulnar joint. The intact DIOM constrained dorsal dislocation of the radius, but it seldom constrained palmar dislocation. A residual ulnar translation deformity of the radial shaft in distal radius fractures has the potential to cause the distal radioulnar joint instability when the triangular fibrocartilage complex injury is also present, because it may result in detensioning of DIOM. Ulnar shortening with the osteotomy performed proximal to the attachment of the DIOM had a more favorable effect on stability of the DRUJ compared with the effect of distal osteotomy, especially in the presence of the distal oblique bundle (DOB). The longitudinal resistance to ulnar shortening was significantly greater in proximal shortening than in distal shortening.
本文旨在综述远侧骨间膜（DIOM）的功能解剖学和生物力学及其与桡尺远侧关节稳定性的相关性。完整的DIOM可限制桡骨背侧脱位，但很少能限制掌侧脱位。当三角纤维软骨复合体损伤也存在时，桡骨远端骨折中桡骨干的残余尺侧平移畸形有可能导致桡尺远侧关节不稳定，因为这可能导致DIOM张力降低。与远侧截骨术相比，在DIOM附着点近端进行截骨术的尺骨短缩对桡尺远侧关节稳定性的影响更有利，尤其是在存在远侧斜束（DOB）的情况下。近端短缩对尺骨短缩的纵向阻力明显大于远端短缩。
