Gammon Braden, Lalone Emily, Nishiwaki Masao, Willing Ryan, Johnson James, King Graham J W
Division of Orthopedics, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada.
Department of Mechanical and Materials Engineering, University of Western Ontario, London, Ontario, Canada.
J Wrist Surg. 2019 Feb;8(1):10-17. doi: 10.1055/s-0038-1667303. Epub 2018 Aug 15.
The effects of dorsal angulation deformity on in vitro distal radioulnar joint (DRUJ) contact patterns are not well understood. The purpose of this study was to utilize intercartilage distance to examine the effects of forearm rotation angle, distal radius deformity, and triangular fibrocartilage complex (TFCC) sectioning on DRUJ contact area and centroid position. An adjustable implant permitted the creation of simulated intact state and dorsal angulation deformities of 10, 20, and 30 degrees. Three-dimensional cartilage models of the distal radius and ulna were created using computed tomography data. Using optically tracked motion data, the relative position of the cartilage models was rendered and used to measure DRUJ cartilage contact mechanics. DRUJ contact area was highest between 10 and 30 degrees of supination. TFCC sectioning caused a significant decrease in contact area with a mean reduction of 11 ± 7 mm between the TFCC intact and sectioned conditions across all variables. The position of the contact centroid moved volarly and proximally with supination for all variables. Deformity had a significant effect on the location of the contact centroid along the volar-dorsal plane. Contact area in the DRUJ was maximal between 10 and 30 degrees of supination during the conditions tested. There was a significant effect of simulated TFCC rupture on contact area in the DRUJ, with a mean contact reduction of 11 ± 7 mm after sectioning. Increasing dorsal angulation caused the contact centroid to move progressively more volar in the sigmoid notch.
背侧成角畸形对体外下尺桡关节（DRUJ）接触模式的影响尚未完全明确。本研究的目的是利用软骨间距离来研究前臂旋转角度、桡骨远端畸形和三角纤维软骨复合体（TFCC）切断对DRUJ接触面积和质心位置的影响。一个可调节的植入物允许创建模拟完整状态以及10度、20度和30度的背侧成角畸形。使用计算机断层扫描数据创建桡骨远端和尺骨的三维软骨模型。利用光学跟踪的运动数据，呈现软骨模型的相对位置并用于测量DRUJ软骨接触力学。DRUJ接触面积在旋前10至30度之间最大。TFCC切断导致接触面积显著减小，在所有变量中，TFCC完整和切断状态之间平均减少11±7平方毫米。对于所有变量，接触质心的位置随着旋前向掌侧和近端移动。畸形对接触质心沿掌背平面的位置有显著影响。在所测试的条件下，DRUJ的接触面积在旋前10至30度之间最大。模拟的TFCC破裂对DRUJ的接触面积有显著影响，切断后平均接触面积减少11±7平方毫米。背侧成角增加导致接触质心在乙状切迹中向掌侧移动得越来越多。
