Angelis Stavros, Apergis Emmanouil, Kanellos Panagiotis, Apostolopoulos Alexandros, Vlasis Konstantinos, Piagkou Maria, Filippou Dimitrios
Anatomy, National and Kapodistrian University of Athens, Athens, GRC.
Orthopaedics, General Hospital Hellenic Red Cross Korgialenio - Benakio, Athens, GRC.
Cureus. 2023 Dec 10;15(12):e50252. doi: 10.7759/cureus.50252. eCollection 2023 Dec.
Background and objective The distal oblique bundle (DOB) is nowadays recognized as the thickest component of the distal interosseous membrane (DIOM). It is neither thought to be a clear-cut ligament, and nor does it follow the typical configuration of the rest of the DIOM. It is not always present and some studies have raised disputes about its prevalence and a few anatomical features. In this study, we aimed to provide data on the prevalence and anatomical features of the DOB, which are of great importance at this early stage of research into the topic. Our findings have been correlated with current knowledge and are expected to contribute to clinical implementation. Materials and methods Twenty-eight fresh-frozen forearms were utilized for measurements. Specifically, mean length, width, distance from the middle of the bundle's insertion to the ulna to the tip of the styloid process of the ulna, as well as the distance from the midpoint of its insertion to the radius to the tip of the radiuses' styloid process were calculated. The prevalence was described with a cutoff thickness point of 0.5 mm. Early results based on three cases of DOB reconstruction with the "Riggenbach" technique due to distal radioulnar joint (DRUJ) instability were documented. Results Eleven DOBs were reported out of the 28 specimens, suggesting a prevalence of 39.3%. The mean thickness was 0.88 mm (range: 0.6-1.3 mm), the mean width was 5.22 mm (range: 2.2-8.4 mm), and the mean length was 25.68 mm (range: 22.7-29.2 mm). Proximally, the mean distance from the bundle's ulnar insertion to the tip of the styloid process of the ulna was 51.02 mm (range: 45.5-55.6 mm) while distally, the mean distance from the bundle's insertion to the radius to the tip of the styloid process of the radius was 34.5 mm (range: 31.3-37.7 mm). After a follow-up of at least six months, improvement was evident in all measured areas in the three patients who underwent surgery. Additionally, they reported satisfaction and accomplishment of their preoperative goals. Conclusions Discrepancies in measurements in some anatomic features between studies are probably due to variations in specimen types, measurement methods, and sites. Efforts must continue to be made on a more extensive scale and in a more standardized manner for more factual results and conclusions. "Reconstruction-recreation" or "original construction-creation" procedures yield promising results in a fast, simple, and less invasive manner than traditional methods of DRUJ stabilization.
背景与目的 远侧斜束（DOB）如今被认为是远侧骨间膜（DIOM）最厚的组成部分。它既不被认为是一条明确的韧带，其形态也不符合DIOM其余部分的典型结构。它并非总是存在，一些研究对其发生率及一些解剖学特征存在争议。在本研究中，我们旨在提供有关DOB发生率及解剖学特征的数据，这些数据在该主题研究的早期阶段非常重要。我们的研究结果已与现有知识相关联，并有望为临床应用做出贡献。
材料与方法 使用28个新鲜冷冻的前臂进行测量。具体而言，计算了平均长度、宽度、束插入点中点至尺骨茎突尖端的距离，以及其插入点中点至桡骨茎突尖端的距离。发生率以0.5毫米的临界厚度点来描述。记录了基于3例因远侧桡尺关节（DRUJ）不稳定采用“里根巴赫”技术进行DOB重建的早期结果。
结果 28个标本中有11个发现了DOB，提示发生率为39.3%。平均厚度为0.88毫米（范围：0.6 - 1.3毫米），平均宽度为5.22毫米（范围：2.2 - 8.4毫米），平均长度为25.68毫米（范围：22.7 - 29.2毫米）。近端，束在尺骨的插入点至尺骨茎突尖端的平均距离为51.02毫米（范围：45.5 - 55.6毫米），而远端，束在桡骨的插入点至桡骨茎突尖端的平均距离为34.5毫米（范围：31.3 - 37.7毫米）。在至少随访6个月后，接受手术的3例患者所有测量区域均有明显改善。此外，他们报告对手术感到满意并实现了术前目标。
结论 不同研究之间在一些解剖学特征测量上存在差异，可能是由于标本类型、测量方法和部位的不同。必须继续以更广泛的规模和更标准化的方式努力，以获得更真实的结果和结论。与传统的DRUJ稳定方法相比，“重建 - 重塑”或“原结构 - 创新”手术以快速、简单且侵入性较小的方式产生了有前景的结果。
