Abstract
BackgroundSome cadaveric studies have reported the role of the distal oblique bundle (DOB) in the distal radioulnar joint stability. We aimed to determine whether the presence of the DOB can be identified and its thickness can be measured in magnetic resonance imaging (MRI) examinations.MethodsWe retrospectively reviewed 468 wrist and forearm MRIs. Inclusion criteria were wrist or forearm MRIs taken in patients older than 18 years of age, and exclusion criteria were patients with acute wrist or forearm fractures, infections, or malignant tumors. We selected 80 MRIs that provided adequate coverage of the distal interosseous membrane (DIOM). The thickness of the DIOM in the T2-weighted transverse plane was measured on the picture archiving and communicating system. We used a model-based clustering method to determine whether some individuals have thicker DIOMs that can be considered as the DOB.ResultsThe thickness of the DIOM demonstrated a bimodal distribution, indicating the presence of patients with a thick DIOM (DOB). The model-based clustering method indicated that the optimal cutoff point was 1.0 mm. Twenty-six individuals (32.5%) had thick DIOMs with a mean thickness of 1.4 mm (standard deviation, 0.2 mm), while 54 individuals (67.5%) had thin DIOMs with a mean thickness of 0.6 mm (standard deviation, 0.2 mm).ConclusionOur study demonstrates that it is possible to identify the DOB and measure its thickness using MRI. Future in-vivo studies of the DOB using MRI in patients with distal radioulnar joint pathologies may reveal its role in the distal radioulnar joint stability.
Highlights
Some cadaveric studies have reported the role of the distal oblique bundle (DOB) in the distal radioulnar joint stability
In these 468 magnetic resonance imaging (MRI), we examined whether the MRI provided sufficient coverage of the length of the distal interosseous membrane (DIOM) that originates from the distal one-sixth of the ulnar shaft and runs toward dorsal and distal direction to insert on the dorsal inferior rim of the sigmoid notch of the radius
Our study demonstrates that the presence of the DOB can be identified and its thickness can be measured in the T2weighted transverse plane of MRI that provides adequate coverage of the wrist and the distal forearm
Summary
Some cadaveric studies have reported the role of the distal oblique bundle (DOB) in the distal radioulnar joint stability. The distal interosseous membrane (DIOM) acts as a secondary stabilizer of the distal radioulnar joint (DRUJ) when the dorsal and palmar radioulnar ligaments of the triangular fibrocartilage complex (TFCC) are cut [1, 2]. Noda et al. Recently, studies have reported the role of the DOB in the DRUJ stability. Kitamura et al reported in a cadaveric study that DRUJ laxity was greater in the group without a DOB than in the group with a DOB [5]. Arimitsu et al found in another cadaveric study that ulnar shortening with the osteotomy carried out proximal to
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