Interosseous membrane anatomy and functional mechanics.

Longitudinal forearm stability is maintained through the interaction of several anatomic structures. One such structure, the interosseous membrane, is a fibrous tissue with an oblique orientation from the radius to the ulna. The membrane maintains the interosseous space between the radius and ulna through forearm rotation and actively transfers forces from the radius to the ulna. The interosseous membrane's unique functional capabilities result from its anatomic and histologic organization, which produces a stiff structure with elastic properties capable of maintaining large loads. The interosseous membrane's load transferring ability reduces the forces placed on the radiocapitellar articulation, thereby protecting this joint. However, large chronic loading results in attenuation of the membrane fibers, thereby reducing longitudinal stability. Large sustained loads occur after radial head resection with concurrent interosseous membrane tears, resulting in the proximal migration of the radius and disruption of the distal radioulnar joint. Ultimately, the treatment option for severe membrane disruption combined with proximal migration of the radius is the creation of a single bone forearm.

[1]  A G Patwardhan,et al.  The role of the interosseous membrane and triangular fibrocartilage complex in forearm stability. , 1994, The Journal of hand surgery.

[2]  Vesely Dg The distal radio-ulnar joint. , 1967 .

[3]  G. Johnston A Follow-up of One Hundred Cases of Fracture of the Head of the Radius with a Review of the Literature , 1962, The Ulster medical journal.

[4]  K. An,et al.  An anatomic and mechanical study of the interosseous membrane of the forearm: pathomechanics of proximal migration of the radius. , 1989, The Journal of hand surgery.

[5]  A. Sarmiento,et al.  The stabilizing effect of soft-tissue constraints in artificial Galeazzi fractures. , 1985, Clinical orthopaedics and related research.

[6]  G. Eichhorn,et al.  Physical chemical studies on the age changes in rat tail tendon collagen. , 1968, Biochimica et biophysica acta.

[7]  M E Nimni,et al.  Collagen: structure, function, and metabolism in normal and fibrotic tissues. , 1983, Seminars in arthritis and rheumatism.

[8]  K. An,et al.  Force transmission through the radial head. , 1985, The Journal of bone and joint surgery. American volume.

[9]  D P Fyhrie,et al.  The interosseous membrane affects load distribution in the forearm. , 1997, The Journal of hand surgery.

[10]  A. Weiland,et al.  Symptomatic Proximal Translation of the Radius Following Radial Head Resection , 1995, Clinical Orthopaedics and Related Research.

[11]  Z. Yosipovitch,et al.  Late results of excision of the radial head for an isolated closed fracture. , 1986, The Journal of bone and joint surgery. American volume.

[12]  B. Denduchis,et al.  Soluble collagens in normal rat skin, from embryo to adulthood. , 1963, Laboratory investigation; a journal of technical methods and pathology.

[13]  T. Taylor,et al.  THE EFFECT UPON THE INFERIOR RADIO-ULNAR JOINT OF EXCISION OF THE HEAD OF THE RADIUS IN ADULTS. , 1964, The Journal of bone and joint surgery. British volume.

[14]  D. Vesely The Distal Radio‐ulnar Joint , 1967, Clinical orthopaedics and related research.

[15]  E. Lipskeir,et al.  Derotation osteotomy of the forearm in management of paralytic supination deformity. , 1993, The Journal of hand surgery.

[16]  J. P. Bentley,et al.  Quantitation of type I to type III collagen ratios in small samples of human tendon, blood vessels, and atherosclerotic plaque. , 1983, Analytical biochemistry.

[17]  A. Palmer,et al.  The effect of dorsally angulated distal radius fractures on distal radioulnar joint congruency and forearm rotation. , 1996, The Journal of hand surgery.

[18]  N. Blumenkrantz,et al.  An assay for hydroxyproline and proline on one sample and a simplified method for hydroxyproline. , 1975, Analytical biochemistry.

[19]  R. Berg Determination of 3- and 4-hydroxyproline. , 1982, Methods in enzymology.

[20]  A. Greenwald,et al.  Reconstructive Strategies for Radioulnar Dissociation: A Biomechanical Study , 1995, Journal of orthopaedic trauma.

[21]  F. Reckling,et al.  RICCARDO GALEAZZI AND GALEAZZI'S FRACTURE. , 1965, Surgery.

[22]  R. Berg [17] Determination of 3- and 4-hydroxyproline , 1982 .

[23]  H. Nakagawa,et al.  Elastin in the Human Posterior Longitudinal Ligament and Spinal Dura A Histologic and Biochemical Study , 1994, Spine.

[24]  H. Bingham A study of adriamycin-reduced wound breaking strength in rats , 1981 .

[25]  A. Sarmiento,et al.  The interosseous membrane of the forearm: structure and its role in Galeazzi fractures. , 1993, The Journal of trauma.

[26]  I. Bergman,et al.  Two Improved and Simplified Methods for the Spectrophotometric Determination of Hydroxyproline. , 1963 .

[27]  Johnston Gw A follow-up of one hundred cases of fracture of the head of the radius with a review of the literature. , 1962 .

[28]  E. Chao,et al.  Biomechanical study of the elbow following excision of the radial head. , 1979, The Journal of bone and joint surgery. American volume.

[29]  J. C. Hughston Fractures of the Forearm: Anatomical Considerations , 1962 .

[30]  L. Robert,et al.  Biochemical characterization of elastin in neointimal hyperplasia of rabbit aorta. , 1989, Matrix.

[31]  A MCDOUGALL,et al.  Subluxation of the inferior radio-ulnar joint complicating fracture of the radial head. , 1957, The Journal of bone and joint surgery. British volume.

[32]  T. Triche,et al.  A study of adriamycin‐reduced wound breaking strength in rats. An evaluation by light and electron microscopy, induction of collagen maturation, and hydroxyproline content , 1980, Cancer.

[33]  P. Gallop,et al.  [31] Elastn isolation and cross-linking , 1982 .

[34]  T. Mommersteeg,et al.  Method to determine collagen density distributions in fibrous tissues , 1993, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[35]  A. Palmer,et al.  Biomechanics of the distal radioulnar joint. , 1984, Clinical orthopaedics and related research.

[36]  N. Hadler,et al.  Phlogistic properties of bacterial debris. , 1978, Seminars in arthritis and rheumatism.

[37]  A. Bailey,et al.  Characterization of the collagen of human hypertrophic and normal scars. , 1975, Biochimica et biophysica acta.

[38]  Y. Takemitsu,et al.  Operation for chronic dislocation of the radial head in children. Reduction by osteotomy of the ulna. , 1987, The Journal of bone and joint surgery. British volume.

[39]  K. An,et al.  Biomechanics of the elbow and forearm. , 1994, Hand clinics.

[40]  Ž. Mikić,et al.  Late results in fractures of the radial head treated by excision. , 1983, Clinical orthopaedics and related research.

[41]  M. Hausman,et al.  The distal radioulnar joint. , 1992, Hand clinics.

[42]  A A HALLS,et al.  Transmission of pressures across the elbow joint , 1964, The Anatomical record.

[43]  R. Pearce,et al.  Age and the chemical constitution of normal human dermis. , 1972, The Journal of investigative dermatology.

[44]  Paralytic supination contracture of the forearm. , 1967, The Journal of bone and joint surgery. American volume.

[45]  J. Shah,et al.  Low tension studies of collagen fibres from ligaments of the human spine. , 1977, Annals of the rheumatic diseases.

[46]  E. Radin,et al.  Fractures of the radial head. A review of eighty-eight cases and analysis of the indications for excision of the radial head and non-operative treatment. , 1966, The Journal of bone and joint surgery. American volume.

[47]  K. Kivirikko,et al.  Modifications of a specific assay for hydroxyproline in urine. , 1967, Analytical biochemistry.

[48]  R. Crystal,et al.  Lung collagen composition and synthesis. Characterization and changes with age. , 1974, The Journal of biological chemistry.