The Distal Radioulnar Joint in Relation to the Whole Forearm

Abstract

The functional anatomy of the distal radioulnar joint was studied in relation to the whole forearm, using three fresh-frozen, above-elbow amputation specimens. The specimens demonstrate how the proximal and distal radioulnar joints together form a bicondylar joint of special character. The proximal "condyle," the radial head, rotates axially, whereas the distal "condyle," the ulnar head, is fixed with respect to rotation. The ordinary articulation of a bicondylar joint (pure axial rotation) is thereby changed into pronation-supination. Axial rotation is preserved proximally, while distally the radius swings around the ulnar head. The mobile radius is distally attached to the stable ulnar head by the dorsal and volar radioulnar ligaments, the dorsal ligament being tight for stabilization in supination and the volar ligament being tight in pronation. The ulnar head also serves as a keystone, carrying the load of the radius. Removal of the ulnar head allows the radius to "fall in" towards the ulna, with narrowing of the interosseous space.