Publication: Reconstrucción mínimamente invasiva de la banda oblicua distal. Estudio anatómico
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2016-08-26
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Universidad Complutense de Madrid
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Abstract
La radioulnar distal es una articulación diartrodial trocoide compuesta por la escotadura sigmoidea del radio y la cabeza ulnar. Su estabilidad depende de la integridad de diversas estructuras como son el complejo fibrocartílago triangular o CFCT, el músculo pronador cuadrado y el músculo extensor ulnar del carpo y la porción distal de la membrana interósea (MIO), fundamentalmente la banda oblicua distal, en los casos en los que se encuentra presente. La banda oblicua distal (BOD) es una estructura independiente de la porción membranosa distal de la membrana interósea la cual ha sido descrita en un 40% de los individuos. Se origina en 1/6 distal de la diáfisis ulnar y se inserta en el borde inferior de la escotadura sigmoidea. Algunas fibras se extienden más distalmente, pareciendo mantener continuidad con los ligamentos radioulnares dorsal y palmar, lo que ha hecho pensar en su función como estabilizador de la articulación radioulnar distal. A su vez, su inserción ulnar coincide con el eje de rotación del antebrazo, experimentando así pocos cambios durante la pronosupinación, comportándose de forma isométrica. El CFCT es el estabilizador primario de la articulación, y en situaciones normales la influencia de la porción distal de la membrana interósea es insustancial. Sin embargo, tras una lesión del fibrocartílago triangular o una resección de la cabeza ulnar, es cuando adquiere un papel fundamental...
The distal radioulnar is a diarthrodial trochoid joint consisting of the sigmoid notch of the radius and the ulnar head. Its stability depends on the integrity of various structures such as the triangular fibrocartilage complex (TFCC), the square pronator, the extensor carpi ulnaris and the distal portion of the interosseous membrane (IOM), mainly the distal oblique band, in cases in which it is present. The distal oblique bundle (DOB) is a structure independent of the distal membranous portion of the interosseous membrane, which has been reported in 40% of individuals. It originates at the distal one-‐sixth of the ulnar diaphysis and is inserted in the lower edge of the sigmoid notch. Some fibers extend more distally, seemingly maintaining continuity with the dorsal and palmar radioulnar ligaments, which suggests that they function as stabilizers of the distal radioulnar joint. Moreover, their ulnar insertion coincides with the forearm rotation axis, thereby undergoing few changes during pronosupination and behaving isometrically. The TFCC is the primary stabilizer of the joint, and, in normal conditions, the influence of the distal portion of the interosseous membrane is insignificant...
The distal radioulnar is a diarthrodial trochoid joint consisting of the sigmoid notch of the radius and the ulnar head. Its stability depends on the integrity of various structures such as the triangular fibrocartilage complex (TFCC), the square pronator, the extensor carpi ulnaris and the distal portion of the interosseous membrane (IOM), mainly the distal oblique band, in cases in which it is present. The distal oblique bundle (DOB) is a structure independent of the distal membranous portion of the interosseous membrane, which has been reported in 40% of individuals. It originates at the distal one-‐sixth of the ulnar diaphysis and is inserted in the lower edge of the sigmoid notch. Some fibers extend more distally, seemingly maintaining continuity with the dorsal and palmar radioulnar ligaments, which suggests that they function as stabilizers of the distal radioulnar joint. Moreover, their ulnar insertion coincides with the forearm rotation axis, thereby undergoing few changes during pronosupination and behaving isometrically. The TFCC is the primary stabilizer of the joint, and, in normal conditions, the influence of the distal portion of the interosseous membrane is insignificant...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Cirugía, leída el 01-12-2015