In vivo three-dimensional displacement of the distal radioulnar joint during resisted forearm rotation.
OBJECTIVE
The in vivo displacement of the distal radioulnar joint (DRUJ) while under resisted pronation or supination has never been previously quantified. Being a joint with 3 dimensions of motion (dorsopalmar translation, changes in ulnar variance, and radioulnar coaptation), our purpose was to determine its 3-dimensional (3D) displacement during resisted rotational torque.


METHODS
Ten normal subjects (aged 31.8 years+/-7.8; F, 5; M, 5) were recruited. Computed tomography scans of a subjects' distal forearms were obtained while grasping the handles of a custom apparatus to keep the fist and forearm in neutral rotation. Scanning was performed in 3 conditions: no rotational torque (control), maximum isometric supination, and maximum isometric pronation. The 3D displacement of the DRUJ, using the ulnar fovea as the reference point, during isometric rotational torque was determined using markerless bone registration techniques.


RESULTS
The mean 3D displacement of the ulnar fovea during maximum isometric pronation and maximum isometric supination was 3.09 mm+/-0.94 and 2.17 mm+/-1.55, respectively. During maximum isometric pronation, the ulnar fovea displaced a mean of 0.51 mm+/-1.79 dorsally. During maximum isometric supination, the ulnar fovea displaced a mean of 0.13 mm+/-2.07 volarly. In both conditions, ulnar variance increased (0.23 mm+/-2.52 for isometric pronation and 0.44 mm+/-1.57 for isometric supination), and there was increased radioulnar coaptation (0.37 mm+/-0.86 for isometric pronation, 0.039 mm+/-0.66 for isometric supination).


CONCLUSIONS
Resisted rotational torque can be applied to the DRUJ while in neutral rotation during computed tomography imaging, producing measurable displacements in 3D. This technique of studying the DRUJ has the potential to improve our ability to detect and quantify instabilities of the DRUJ.
Tay
Shian Chao
SC
Orthopaedics Biomechanics Laboratory, the Division of Hand Surgery, the Department of Radiology, and the Mayo Graduate School, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
Berger
Richard A
RA
Tomita
Kazunari
K
Tan
Ek Tsoon
ET
Amrami
Kimberly K
KK
An
Kai-Nan
KN
D000328:Adult; D001696:Biomechanical Phenomena; D005260:Female; D005542:Forearm / Q000000981:diagnostic imaging / Q000502:physiology*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D015588:Observer Variation; D011403:Pronation; D011884:Radius / Q000000981:diagnostic imaging / Q000502:physiology; D012399:Rotation; D013484:Supination; D014057:Tomography, X-Ray Computed; D019415:Torque; D014457:Ulna / Q000000981:diagnostic imaging / Q000502:physiology; D014955:Wrist Joint / Q000000981:diagnostic imaging / Q000502:physiology*