title: Distal radioulnar joint instability in distal radius fractures: the role of sigmoid notch and triangular fibrocartilage complex revisited.
abstract: The stabilising effects of various structures of the distal radioulnar joint (DRUJ) have been heavily debated. This biomechanical cadaveric study examined the effects of the volar and dorsal lips of the sigmoid notch and the volar and dorsal aspects of the triangular fibrocartilage complex (TFCC) on DRUJ stability. Sequential fractures of the distal radius and sectioning of the TFCC were performed followed by measurements of ulnar translation with the forearm in pronation, neutral and supination. A dorsal lunate facet fracture created instability in pronation. Lunate facet fractures alone did not create instability in other forearm positions. Sectioning of the volar TFCC after loss of the dorsal TFCC by a dorsal lunate facet fracture caused DRUJ instability with the forearm in neutral position. Sectioning of the dorsal TFCC after loss of the volar TFCC due to a volar lunate facet fracture created instability in neutral and pronated positions.
authors.affiliation: Wake Forest University School of Medicine, Department of Orthopaedic Surgery, Medical Center Boulevard, Winston-Salem, NC 27157, USA. dcole@wfubmc.edu
authors.forename: David W
authors.initials: DW
authors.lastname: Cole
authors.forename: Gamal A
authors.initials: GA
authors.lastname: Elsaidi
authors.forename: Kevin R
authors.initials: KR
authors.lastname: Kuzma
authors.forename: Gary R
authors.initials: GR
authors.lastname: Kuzma
authors.forename: Beth P
authors.initials: BP
authors.lastname: Smith
authors.forename: David S
authors.initials: DS
authors.lastname: Ruch
mesh_terms: D001696:Biomechanical Phenomena; D002102:Cadaver; D002358:Cartilage, Articular / Q000502:physiology; D005542:Forearm / Q000502:physiology*; D006801:Humans; D007593:Joint Instability / Q000503:physiopathology*; D008023:Ligaments, Articular / Q000502:physiology; D011403:Pronation; D011884:Radius / Q000502:physiology; D011885:Radius Fractures / Q000503:physiopathology*; D013484:Supination; D014457:Ulna / Q000502:physiology; D014955:Wrist Joint / Q000502:physiology* / Q000503:physiopathology