Department of Hand Surgery, Affiliated Hospital of Nantong University, College of Medicine, University of Nantong, Nantong, China.
Department of Hand Surgery, Affiliated Hospital of Nantong University, Nantong, China.
J Hand Surg Am. 2024 May;49(5):486.e1-486.e5. doi: 10.1016/j.jhsa.2022.06.007. Epub 2022 Aug 6.
The length change of the interosseous membrane (IOM) during forearm rotation has not been fully studied. To explore the meaning of length change in the distal oblique band (DOB), the distal accessory band (DAB), and the proximal, middle, and distal parts of the central band (CBP, CBM, and CBD, respectively), we investigated the length change in these ligaments at maximum pronation, 45° of pronation, neutral position, 45° of supination, and maximum supination in vivo.
The images of the right forearms from 6 healthy volunteers were obtained by computed tomography scanning at the 5 above-mentioned rotation positions. We created 3-dimensional models of the radius and ulna, DOB, DAB, and central band based on the points of origin and insertion. Finally, the length of each ligament was estimated from the points of insertions and origins registered on the 3-dimensional models.
The DAB and CBD lengths increased significantly from maximum pronation to 45° of pronation. The DOB length increased significantly from 45° of pronation to neutral position and decreased significantly from 45° of supination to maximum supination. The DAB and CBM lengths increased significantly from neutral position to 45° of supination. The DAB length decreased significantly from 45° of supination to maximum supination. For the CBP, no difference in length was observed during forearm rotation.
The DOB becomes taut at neutral position, and the central band, especially the CBP, is nearly isometric. The findings indicate that the DOB may provide the primary stabilization of the distal radioulnar joint and that the central band is the key stabilizer during forearm rotation.
Surgeons may pay attention to the DOB when a patient incurs a distal radioulnar joint injury, and the CBP may be the optimal location for IOM reconstruction.
前臂旋转过程中骨间膜（IOM）的长度变化尚未得到充分研究。为了探讨远端斜束（DOB）、远端辅助束（DAB）以及中央束近端、中部和远端（CBP、CBM 和 CBD）的长度变化的意义，我们在活体中研究了这些韧带在最大旋前位、45°旋前位、中立位、45°旋后位和最大旋后位时的长度变化。
对 6 名健康志愿者的右前臂进行了 5 种旋转位置的计算机断层扫描，获得了图像。我们基于起点和止点创建了桡骨和尺骨、DOB、DAB 和中央束的三维模型。最后，根据在三维模型上注册的起点和止点估计每条韧带的长度。
DAB 和 CBD 长度从最大旋前位到 45°旋前位显著增加。DOB 长度从 45°旋前位到中立位显著增加，从 45°旋后位到最大旋后位显著减少。DAB 和 CBM 长度从中立位到 45°旋后位显著增加。DAB 长度从 45°旋后位到最大旋后位显著减少。对于 CBP，前臂旋转过程中长度没有差异。
DOB 在中立位时拉紧，中央束，尤其是 CBP，几乎等长。研究结果表明，DOB 可能为下尺桡关节的主要稳定提供支持，而中央束是前臂旋转时的关键稳定器。
当患者发生下尺桡关节损伤时，外科医生可能会注意到 DOB，而 CBP 可能是 IOM 重建的最佳位置。
