Shin Won-Jeong, Kim Jong-Pil, Yang Hun-Mu, Lee Eun-Young, Go Jai-Hyang, Heo Kang
Department of Orthopedic Surgery, College of Medicine; Department of Kinesiology and Medical Science, Graduate School, Dankook University, Seoul, Korea.
Department of Orthopedic Surgery, College of Medicine; Department of Kinesiology and Medical Science, Graduate School, Dankook University, Seoul, Korea.
J Hand Surg Am. 2017 Jul;42(7):517-524. doi: 10.1016/j.jhsa.2017.03.031. Epub 2017 Apr 25.
The deep component of the distal radioulnar ligament provides translational stability and rotational guidance to the forearm. However, controversy exists regarding the importance of this structure as well as the nature of its attachment to the distal ulna. We aimed to evaluate the topographic anatomy of the distal ulna attachment of both the superficial and the deep components of the radioulnar ligament and to assess the relationship between its internal and its external morphometry.
Thirteen human distal ulnae attached by ulnar part of the distal radioulnar ligament were scanned using micro-computed tomography and reconstructed in 3 dimensions. In addition, the distal radioulnar ligaments were examined under polarized light microscopy to determine the histological characteristics of collagen contained within the ligaments.
The deep limbs have broad marginal insertions at the fovea, whereas the superficial limbs have a circular and condensed insertion to the ulnar styloid. The center of the deep limb was separated from the base of the ulnar styloid by a mean of 2.0 ± 0.76 mm, and this distance was positively correlated with the width of the ulnar styloid. The mean distance between the center of the ulnar head and the center of the fovea was 2.4 ± 0.58 mm. The proportion of collagen type I was lower in the deep limb than in the superficial limb.
This new observation of the footprint of the radioulnar ligament in the distal ulna indicates that the deep limb may serve as an internal capsular ligament of the distal radioulnar joint, whereas the superficial limb as the external ligament.
Knowledge of the topographic anatomy of the radioulnar ligament's attachment to the distal ulna may provide a better understanding of distal radioulnar ligament-related pathologies.
桡尺远侧韧带的深层部分为前臂提供平移稳定性和旋转导向。然而，关于该结构的重要性及其与尺骨远端附着的性质存在争议。我们旨在评估桡尺韧带浅层和深层部分在尺骨远端的附着部位的局部解剖结构，并评估其内部和外部形态测量之间的关系。
使用微型计算机断层扫描对13个通过桡尺远侧韧带尺侧部分附着的人类尺骨远端进行扫描，并进行三维重建。此外，在偏振光显微镜下检查桡尺远侧韧带，以确定韧带内所含胶原蛋白的组织学特征。
深层肢体在凹处有宽阔的边缘附着，而浅层肢体在尺骨茎突有圆形且密集的附着。深层肢体的中心与尺骨茎突基部的平均距离为2.0±0.76mm，且该距离与尺骨茎突的宽度呈正相关。尺骨头中心与凹中心之间的平均距离为2.4±0.58mm。深层肢体中I型胶原蛋白的比例低于浅层肢体。
对桡尺韧带在尺骨远端附着部位的这一新观察表明，深层肢体可能作为桡尺远侧关节的内部囊韧带，而浅层肢体作为外部韧带。
了解桡尺韧带在尺骨远端的附着部位的局部解剖结构可能有助于更好地理解与桡尺远侧韧带相关的病理情况。
