The Effect of Dorsal Angulation on Distal Radioulnar Joint Arthrokinematics Measured Using Intercartilage Distance.

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.