Distal Radioulnar Joint Kinematics in Simulated Dorsally Angulated Distal Radius Fractures

Purpose To examine the effects of dorsal angulation deformities of the distal radius with and without triangular fibrocartilage complex (TFCC) rupture on the 3-dimensional kinematics of the distal radioulnar joint (DRUJ) during simulated active motion. Methods Nine fresh-frozen cadaveric specimens were tested in a forearm simulator that produced active forearm rotation. Dorsal angulation deformities of the distal radius with 100, 20, and 30 angulation were created. Changes in the position of the ulna relative to the radius at the DRUJ as a consequence of each dorsal angulation deformity were quantified during simulated active supination in terms of volar, ulnar, and distal displacement of the ulna. Testing was performed initially with the TFCC intact and repeated after complete sectioning of the TFCC at its ulnar insertion. Results Increasing dorsal angulation deformities of the distal radius significantly increased volar, ulnar, and distal displacement of the ulna when the TFCC was intact. Sectioning of the TFCC significantly increased volar displacement of the ulna in dorsal angulation deformities. As little as 10 of dorsal angulation significantly increased distal displacement of the ulna with the TFCC intact and resulted in a significant increase in volar, ulnar, and distal displacement of the ulna with sectioned TFCC. Conclusions Dorsal angulation deformities of the distal radius affect the 3-dimensional kinematics of the DRUJ, especially with the TFCC sectioned. (Copyright (C) 2014 by the American Society for Surgery of the Hand. All rights reserved.)