Interosseous Membrane Of Forearm Research Articles

The “muscular hernia sign”: an original ultrasonographic sign to detect lesions of the forearm’s interosseous membrane

The total disruption of the forearm's interosseous membrane can lead to an Essex-Lopresti syndrome. The diagnosis must be done early for a better prognostic. Incomplete lesions can aggravate and an early diagnosis of incomplete lesions is a challenging problem. Magnetic resonance imaging is the gold standard but remains expensive, and is hard to obtain in an emergency. On the contrary, ultrasonography is cheap, accessible in an emergency, and dynamical tests can be performed easily. Twelve fresh frozen forearms were randomized in four groups. The membrane was divided into three parts (proximal, middle, and distal thirds). Each group was prepared with variable patterns of lesions. Two radiologists performed an ultrasonographic (US) examination of these forearms. They were blinded with respect to the lesional status of the forearms. Each examination consisted of two stages: static and dynamic. During the dynamic examination, the radiologist looked for the "muscular hernia sign". The results of their examinations were compared with the real lesional status. The static examination was very efficient in the proximal and middle parts of the membrane, and less reliable in the distal third. With the dynamical examination, no mistake occurred at the proximal and middle parts of the forearm, and there was only one at the distal part. The US examination of the interosseous membrane is very efficient to detect incomplete lesions, mostly, if dynamical tests are performed looking for a "muscular hernia sign".

Pronation contracture of the forearm due to iatrogenic scar formation of the distal membranous part of the forearm interosseous membrane

A case of successful treatment of pronation contracture of the forearm due to iatrogenic scar formation in the distal membranous part of the interosseous membrane of the forearm is presented and the management of this problem is discussed.

Divergent Dislocation of Elbow with Ipsilateral Distal Radioulnar Joint Dislocation in a Gymnast

Divergent dislocation of the elbow is a rare injury. It is a result of longitudinal disruption of interosseous membrane of forearm. Although it can logically result in disruption of distal radioulnar joint, according to the authors’ knowledge this combination has not been reported before. The case of a young gymnast is presented who suffered this injury. She was treated successfully in a hinged external fixator and with stabilization of distal radioulnar joint by a K-wire. She regained almost full range of movement and returned to national level gymnastics.

Diagnosis and Treatment of Longitudinal Instability of the Forearm

Radio-ulnar dissociation can result from high-injury trauma that the compressive forces traverse the wrist forearm and elbow. This injury can be thought of as an "unhappy triad" of radial head fracture, triangular fibrocartilage complex failure, and a tear of the interosseous membrane. The radius is the primary stabilizer of the forearm with the forearm interosseous membrane enabling load sharing between the radius and the ulna. The central one-third of the interosseous membrane is 3 times stronger than the membranous portion and approaches the strength of the anterior cruciate ligament for determining interosseous membrane injury. Imaging studies with proven diagnostic efficacy include magnetic resonance imaging and ultrasound. Surgical treatment should be considered when circumstances imply longitudinal instability of the forearm. Surgical treatment includes open reduction/internal fixation or prosthetic replacement of the radial head as well as repair of the disrupted triangular fibrocartilage complex. Successful treatment of radioulnar dissociation is predicated on early diagnosis of the condition.

The anatomy of the ulnocarpal complex

The ulnocarpal complex (triangular fibrocartilage complex; TFCC) represents an intricate system of structures which secures motion guidance, stability and pressure transmission in the ulnocarpal compartment of the wrist joint. Anatomically, this complex consists of the ulnocarpal disc (triangular disc), palmar and dorsal radioulnar ligaments, ulnolunate, ulnotriquetral and ulnocapitate ligaments, ulnocarpal meniscus homologue, ulnar recess (prestyloid recess), ulnocarpal collateral ligament and tendon sheath of the extensor carpi ulnaris. The distal radioulnar joint and the interosseous membrane of the forearm, which lie close together, also belong functionally to the ulnocarpal complex. Together with the proximal radioulnar joint, they permit rotational movements of the hand (pronation and supination). This review highlights all components of the ulnocarpal complex systematically. Distinctive characteristics involving size, as well as variations, are listed, and their functional meaning analyzed. The accumulated knowledge serves as a basis for possible interventions both at the ulnocarpal complex and the distal radioulnar joint.

Ultrasonography for the interosseous membrane of the forearm.

The ability to improve the technique for an accurate clinical diagnosis of the injury of interosseous membrane of the forearm (IOM) associated with forearm fractures and dislocations is important for its treatment and prognosis. Ultrasound examination of the IOM in 46 forearms from 18 normal volunteers, five patients with restricted forearm pronation and supination, and two preoperative cases was performed to determine the usefulness and reproductivity of this examination. The intact IOM was observed as a continuous, slightly convex anteriorly and hyperechoic structure between the radius and ulna with both transverse and longitudinal views. IOMs with histories of forearm injuries were distinguished by the findings, which demonstrated a loss of continuity and were seen as hypoechoic traces from the others. This study confirmed that it is possible to trace the entire IOM and to detect differences between intact and disrupted IOMs with transverse and longitudinal views.

Biochemical composition and histologic structure of the forearm interosseous membrane

Purpose: The purpose of this study was to determine the structure and composition of the forearm interosseous membrane (IOM). Methods: The IOM of 12 cadaver forearms was fixed in formalin. After fixation 5 individual IOM fiber bundles per arm were separated by dissection, excised, and processed with hematoxylin-eosin, trichrome, and Verhoff-vanGeison stains. Nine additional fresh forearms were dissected and 5 IOM fiber bundles per arm were analyzed using the hydroxyproline assay. Bundles were evaluated at ulnar, central, and radial locations. Results: Histologic analysis of the IOM bundles obtained from the 12 fixed forearms showed an abundance of collagen in the main bundle central location (84% ± 7.8%). A progressive increase in collagen was noted from distal to proximal bundles (r =.72). The hydroxyproline assay of collagen content of the main IOM bundle's central location from the 9 additional fresh forearms was 99.3% ± 16.5%. There was no difference between bundles or location (power = 0.25 and 0.46). Conclusions: We found that the IOM possesses a large collagen content arranged in fibrillar structures surrounded by elastin. Collagen was abundant in the proximal bundles and decreased in the distal bundles. (J Hand Surg 2003;28A:503-510. Copyright © 2003 by the American Society for Surgery of the Hand.)

The efficacy of magnetic resonance imaging and ultrasound in detecting disruptions of the forearm interosseous membrane: a cadaver study.

The purpose of this study was to examine the efficacy of magnetic resonance imaging (MRI) and ultrasound (US) in determining complete disruptions of the central portion of the forearm interosseous membrane. The midportion of the forearm interosseous ligament was longitudinally incised in 19 fresh-frozen cadaver arms. The specimens were imaged with MRI and US. The MRIs were examined by a hand surgeon, a musculoskeletal radiologist, and a general radiologist, all blinded to the state of the interosseous membrane. The musculoskeletal radiologist and general radiologists read the real-time US images in a consensus fashion. Magnetic resonance imaging showed a 96% accuracy rate, a 100% positive predictive value, a 93% negative predictive value, 93% sensitivity, and 100% specificity. Kappa analysis showed substantial interobserver agreement for MRI. Ultrasound showed a 94% accuracy rate, a 94% positive predictive value, a 100% negative predictive value, 100% sensitivity, and 89% specificity. There was no statistical significance between the accuracy of MRI and US. We conclude that MRI and US imaging should both be considered when forearm interosseous membrane integrity is in question.

Magnetic Resonance Imaging or Ultrasound in Assessment of the Interosseous Membrane of the Forearm

Magnetic Resonance Imaging or Ultrasound in Assessment of the Interosseous Membrane of the Forearm

Ultrasonography for the evaluation of forearm interosseous membrane disruption in a cadaver model.

Recognition of interosseous membrane disruption associated with radial head injury and Essex-Lopresti injury is important, especially if radial head excision is contemplated. Because a widely accepted method to diagnose interosseous membrane disruption does not exist, we evaluated the accuracy of ultrasonography to diagnose this injury in a cadaver model. Nine pairs of cadaver forearms were randomized into 2 groups. The central third of the interosseous membrane of forearms of group 1 was cut, whereas it was visualized but not cut in group 2. A dynamic ultrasound examination was performed to determine interosseous membrane integrity, and static images were made. The static images were evaluated by 2 other radiologists and interpretations were recorded. One radiologist incorrectly interpreted 1 pair of forearms; the other 2 radiologists were 100% accurate. The accuracy of ultrasonography in detecting interosseous injuries was 96% with our methods.

Interosseous membrane of the forearm

The interosseous membrane of the forearm is a complex anatomic structure responsible for load sharing and stability of the forearm and distal radioulnar joint. The interosseous membrane consists of 2 components: a thin, flexible membranous component located proximal and distal to a stiff, relatively thick central band. The central band is responsible for significant load transfer from the distal radius to the proximal ulna when there is no contact at the radiocapitellar joint. In the Essex-Lopresti injury, the central band is disrupted, along with a displaced radial head fracture and a tear of the triangular fibrocartilage complex. This injury must be recognized early to optimize surgical results. Early treatment includes open reduction with internal fixation of radial head or radial head replacement (allograft or metal), repair of triangular fibrocartilage complex, pinning of distal radioulnar joint, and possibly repair of the central band. Chronic Essex-Lopresti injuries have unpredictable results and may end up being salvaged with a 1-bone forearm. Copyright © 2001 by the American Society for Surgery of the Hand

Magnetic resonance imaging of the interosseous membrane of the forearm.

Diagnosis of damage to the interosseous membrane of the forearm after trauma is difficult. Patients with a proximal radial fracture and associated damage to the interosseous membrane may have wrist pain in association with subluxation or dislocation of the distal radioulnar joint. Accurate identification of injury to the interosseous membrane may allow better planning of surgical treatment. T1 and T2-weighted magnetic resonance images that were made in the axial, sagittal, and coronal planes were used to evaluate the interosseous membrane in the forearms of cadavera, volunteers, and patients. The images were evaluated subjectively by two orthopaedic surgeons and a musculoskeletal radiologist. The interosseous membrane was most consistently visualized on the axial images. Axial T2-weighted images showed the interosseous membrane clearly. The addition of fat-suppression techniques allowed abnormalities to be identified more accurately. Fast-spin-echo techniques were used to obtain data quickly and accurately. The intact and disrupted interosseous membrane can be evaluated with use of magnetic resonance imaging. Axial T2-weighted fast-spin-echo images with fat suppression in the middle one-third of the forearm provide the most accurate information.

Ultrasound and the diagnosis of orthopaedic disorders.

The Journal of Bone and Joint Surgery. British volumeVol. 81-B, No. 6 Review ArticlesFree AccessULTRASOUND AND THE DIAGNOSIS OF ORTHOPAEDIC DISORDERSG. M. Allen, D. J. WilsonG. M. AllenSearch for more papers by this author, D. J. WilsonSearch for more papers by this authorPublished Online:1 Nov 1999https://doi.org/10.1302/0301-620X.81B6.0810944AboutSectionsPDF/EPUB ToolsAdd to FavouritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InRedditEmail FiguresReferencesRelatedDetailsCited byMonitoramento da evolução do tratamento da ausência de consolidação da fratura: Papel da fosfatase alcalina e da ultrassonografia7 December 2021 | Revista Brasileira de Ortopedia, Vol. 56, No. 06Imaging of the limping childEuropean Journal of Radiology, Vol. 109Ultrasound Evaluation of Ulnar Nerve Anatomy in the Pediatric PopulationJournal of Pediatric Orthopaedics, Vol. 32, No. 6The role of ultrasound and magnetic resonance imaging in the evaluation of the forearm interosseous membrane. A review20 May 2011 | Skeletal Radiology, Vol. 40, No. 12A prospective study of pyogenic sepsis of the hip in childhoodT. R. Nunn, W. Y. Cheung, P. D. Rollinson1 January 2007 | The Journal of Bone and Joint Surgery. British volume, Vol. 89-B, No. 1Review Article Diagnostic Ultrasonography: Applications In Orthopaedic SurgeryClinical Orthopaedics and Related Research, Vol. 401 Vol. 81-B, No. 6 Metrics History Published online 1 November 1999 Published in print 1 November 1999 InformationCopyright © 1999, The British Editorial Society of Bone and Joint Surgery: All rights reservedPDF download

(51) Ossification in the interosseous membrane of the forearm after etretinate treatement for psoriasis

(51) Ossification in the interosseous membrane of the forearm after etretinate treatement for psoriasis