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Please use this identifier to cite or link to this item: http://hdl.handle.net/10564/3428

Title: Biomechanical study of isolated radial head dislocation.
Other Titles: 橈骨頭単独脱臼に関する生体力学的研究
Authors: Hayami, Naoki
Omokawa, Shohei
Iida, Akio
Kraisarin, Jirachart
Moritomo, Hisao
Mahakkanukrauh, Pasuk
Shimizu, Takamasa
Kawamura, Kenji
Tanaka, Yasuhito
Keywords: Radial head dislocation
Biomechanical study
Annular ligament
Quadrate ligament
Interosseous membrane
Ligament reconstruction
Issue Date: 21-Nov-2017
Publisher: BioMed Central
Citation: BMC musculoskeletal disorders Vol.18 No.1 Article No.470 (2017 Nov)
Abstract: BACKGROUND: Isolated radial head dislocation is a rare injury with an unclear pathomechanism, and the treatment is controversial. The purpose of the present study was to investigate the biomechanical contributions of the annular ligament, quadrate ligament, interosseous membrane, and annular ligament reconstructions to proximal radioulnar joint stability. METHODS: Five fresh frozen cadaveric upper extremities were amputated above the elbow and solidly fixed on a customized jig. Radial head dislocation was reproduced by sequential sectioning of ligamentous structures and passive mobility testing. Radial head displacement during mobility testing was measured with an electromagnetic tracking device in three forearm rotation positions. The data were compared among different sectioning stages and between two types of simulated ligamentous reconstruction. RESULTS: Lateral displacement of the radial head significantly increased in the neutral forearm rotation after annular ligament sectioning (46 ± 10%, p < 0.05). After quadrate ligament sectioning, we found significant posterior (67 ± 36%, p < 0.05) and lateral (74 ± 24%, p < 0.01) displacement in neutral forearm rotation and pronation. Significant radial head displacement was found in all directions and in all forearm positions after sequential sectioning of the proximal half of the interosseous membrane. Anatomical annular ligament reconstruction stabilized the proximal radioulnar joint except for anterior laxity in neutral forearm rotation (15 ± 6%, p < 0.05). The radial head with Bell Tawse procedure was significantly displaced in all directions. CONCLUSION: The direction of radial head instability varied depending on the degree of soft tissue sectioning and specific forearm rotation. Anterior radial head dislocation may involve more severe ligament damage than other types of dislocation. Anatomical annular ligament reconstruction provided multidirectional radial head stability.
Description: 博士(医学)・甲第683号・平成30年3月15日
© The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
URI: http://hdl.handle.net/10564/3428
ISSN: 14712474
Academic Degrees and number: 24601A683
Degree-granting date: 2018-03-15
Degree name: 博士(医学)
Degree-granting institutions: 奈良県立医科大学
Appears in Collections:2017年度

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