The aim of this study was to clarify the effects of morphological patterns of the sigmoid notch on the stress distribution across the articular surface of the distal radioulnar joint using a computed tomography osteoabsorptiometry method. Fourteen wrists from 13 patients were classified into two groups according to the type of sigmoid notch, namely the ‘C’ type and ski-slope sigmoids, and the percentages of high-density areas on the articular surface were quantitatively analysed. The percentage of the high-density area of the dorsal region in the ski-slope sigmoid group was significantly greater than that of the ‘C’ type sigmoid group (16% vs 4.1%) and of the volar region of the ski-slope sigmoid group (16% vs 2.4%). The results indicate that bony morphological differences in the radial sigmoid notch affect the stress distribution pattern through the distal radioulnar joint.
af EkenstamFHagertCG. Anatomical studies on the geometry and stability of the distal radio ulnar joint. Scand J Plast Reconstr Surg. 1985, 19: 17–25.
2.
DeshmukhSCShanahanDCoulthardD. Distal radioulnar joint incongruity after shortening of the ulna. J Hand Surg Br. 2000, 25: 434–8.
3.
EcksteinFLoheFMuller-GerblMSteinlechnerMPutzR. Stress distribution in the trochlear notch. A model of bicentric load transmission through joints. J Bone Joint Surg Br. 1994, 76: 647–53.
4.
GelbermanRHSalamonPBJuristJMPoschJL. Ulnar variance in Kienböck's disease. J Bone Joint Surg Am. 1975, 57: 674–6.
5.
HollevoetNVerdonkRVan MaeleG. The influence of articular morphology on non-traumatic degenerative changes of the distal radioulnar joint. A radiographic study. J Hand Surg Br. 2006, 31: 221–5.
6.
IidaAOmokawaSMoritomoHet al.Effect of wrist position on distal radioulnar joint stability: a biomechanical study. J Orthop Res. 2014, 32: 1247–51.
7.
IwasakiNIshikawaJKatoHMinamiMMinamiA. Factors affecting results of ulnar shortening for ulnar impaction syndrome. Clin Orthop Relat Res. 2007, 465: 215–9.
8.
KitamuraTMoritomoHArimitsuSet al.The biomechanical effect of the distal interosseous membrane on distal radioulnar joint stability: a preliminary anatomic study. J Hand Surg Am. 2011, 36: 1626–30.
9.
LinscheidRL. Biomechanics of the distal radioulnar joint. Clin Orthop Relat Res. 1992, 275: 46–55.
10.
MinamiAKatoH. Ulnar shortening for triangular fibrocartilage complex tears associated with ulnar positive variance. J Hand Surg Am. 1998, 23: 904–8.
11.
MirarchiAJHoyenHAKnutsonJLewisS. Cadaveric biomechanical analysis of the distal radioulnar joint: influence of wrist isolation on accurate measurement and the effect of ulnar styloid fracture on stability. J Hand Surg Am. 2008, 33: 683–90.
12.
MiuraTFiroozbakhshKCheemaTMoneimMSEdmundsMMeltzerS. Dynamic effects of joint-leveling procedure on pressure at the distal radioulnar joint. J Hand Surg Am. 2005, 30: 711–8.
13.
MommaDIwasakiNOizumiNet al.Long-term stress distribution patterns across the elbow joint in baseball players assessed by computed tomography osteoabsorptiometry. Am J Sports Med. 2011, 39: 336–41.
14.
Muller-GerblMPutzRHodappNSchulteEWimmerB. Computed tomography-osteoabsorptiometry for assessing the density distribution of subchondral bone as a measure of long-term mechanical adaptation in individual joints. Skeletal Radiol. 1989, 18: 507–12.
15.
Muller-GerblMPutzRHodappNHSchultaEWimmerB. Computed tomography-osteoaboorptiometry: a method of assessing the mechanical condition of the major joints in a living subject. Clin Biomech (Bristol, Avon). 1990, 5: 193–8.
16.
NishiwakiMNakamuraTNaguraTToyamaYIkegamiH. Ulnar-shortening effect on distal radioulnar joint pressure: a biomechanical study. J Hand Surg Am. 2008, 33: 198–205.
17.
NishiwakiMNakamuraTNakaoYNaguraTToyamaY. Ulnar shortening effect on distal radioulnar joint stability: a biomechanical study. J Hand Surg Am. 2005, 30: 719–26.
18.
RossMWiemannMPetersSEBensonRCouzensGB. The influence of cartilage thickness at the sigmoid notch on inclination at the distal radioulnar joint. Bone Joint J. 2017, 99: 369–75.
19.
SagermanSDZogbyRGPalmerAKWernerFWFortinoMD. Relative articular inclination of the distal radioulnar joint: a radiographic study. J Hand Surg Am. 1995, 20: 597–601.
20.
ShaabanHGiakasGBoltonMWilliamsRSchekerLRLeesVC. The distal radioulnar joint as a load-bearing mechanism—a biomechanical study. J Hand Surg Am. 2004, 29: 85–95.
21.
ShaabanHGiakasGBoltonMet al.Contact area inside the distal radioulnar joint: effect of axial loading and position of the forearm. Clin Biomech (Bristol, Avon). 2007, 22: 313–8.
22.
Shin SH, Lee YS, Choi KY, Kwak DS, Chung YG. During forearm rotation the three-dimensional ulnolunate distance is affected more by translation of the ulnar head than change in ulnar variance. J Hand Surg Eur. Epub ahead of print, 4 September 2018. DOI: 10.1177/1753193418795638.
23.
TaySCBergerRATomitaKTanETAmramiKKAnKN. In vivo three-dimensional displacement of the distal radioulnar joint during resisted forearm rotation. J Hand Surg Am. 2007, 32: 450–8.
24.
TolatARSandersonPLDe SmetLStanleyJK. The gymnast's wrist: acquired positive ulnar variance following chronic epiphyseal injury. J Hand Surg Br. 1992, 17: 678–81.
25.
TolatARStanleyJKTrailIA. A cadaveric study of the anatomy and stability of the distal radioulnar joint in the coronal and transverse planes. J Hand Surg Br. 1996, 21: 587–94.
26.
WernerFWPalmerAKFortinoMDShortWH. Force transmission through the distal ulna: effect of ulnar variance, lunate fossa angulation, and radial and palmar tilt of the distal radius. J Hand Surg Am. 1992, 17: 423–8.
