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Open Access 01-12-2017 | Research article

Biomechanical study of isolated radial head dislocation

Authors: Naoki Hayami, Shohei Omokawa, Akio Iida, Jirachart Kraisarin, Hisao Moritomo, Pasuk Mahakkanukrauh, Takamasa Shimizu, Kenji Kawamura, Yasuhito Tanaka

Published in: BMC Musculoskeletal Disorders | Issue 1/2017

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.

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Title: Biomechanical study of isolated radial head dislocation
Authors: Naoki Hayami
Shohei Omokawa
Akio Iida
Jirachart Kraisarin
Hisao Moritomo
Pasuk Mahakkanukrauh
Takamasa Shimizu
Kenji Kawamura
Yasuhito Tanaka
Publication date: 01-12-2017
Publisher: BioMed Central
Published in: BMC Musculoskeletal Disorders / Issue 1/2017
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-017-1829-1

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Springer Medicine

Biomechanical study of isolated radial head dislocation

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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