Biomechanical invasive reconstruction of the distal oblique band of the interosseous membrane with extensor carpi radialis longus in radioulnar instability: A new clinical therapy for athletes

Abstract

Distal Radioulnar Joint (DRUJ) instability is a pathology without a clear reconstructive procedure. Throughout history, numerous techniques have been described whose objectives have been to increase stability as well as relieve pain. The main stabilizing element is the Triangular Fibrocartilage Complex (TFCC) and, there are also secondary stabilizers among where the Distal Oblique Bundle (DOB) is consistently located. We performed a biomechanical study with three cadaveric arms to verify the influence of DOB on joint stability and performing a new reconstruction technique with hemi tendon of carpi radialis longus extensor to get distal radio cubital stability for fiber cartilage repair. There are positive results in the volar and dorsal displacement of the ulna on the radius with the reconstruction technique presented to restore joint stability. The proposed technique is a valid and biomechanically effective option to restore joint stability as a complement to the repair of the TFCC or as a unique technique if the TFCC is irreparable. This technique became important when you cannot repair TFCC in athletes, the recommended alternative can be done and distal oblique soft plasty.