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Effect of soft tissue injury and ulnar angulation on radial head instability in a Bado type I Monteggia fracture model

The effects of soft tissue damage and ulnar angulation deformity on radial head instability in Monteggia fractures are unclear. We tested the hypothesis that radial head instability correlates with the magnitude of ulnar angular deformity and the degree of proximal forearm soft tissue injury in Bado...

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Autores principales: Hayami, Naoki, Omokawa, Shohei, Iida, Akio, Kira, Tsutomu, Moritomo, Hisao, Mahakkanukrauh, Pasuk, Kraisarin, Jirachart, Shimizu, Takamasa, Kawamura, Kenji, Tanaka, Yasuhito
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6946299/
https://www.ncbi.nlm.nih.gov/pubmed/31689815
http://dx.doi.org/10.1097/MD.0000000000017728
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author Hayami, Naoki
Omokawa, Shohei
Iida, Akio
Kira, Tsutomu
Moritomo, Hisao
Mahakkanukrauh, Pasuk
Kraisarin, Jirachart
Shimizu, Takamasa
Kawamura, Kenji
Tanaka, Yasuhito
author_facet Hayami, Naoki
Omokawa, Shohei
Iida, Akio
Kira, Tsutomu
Moritomo, Hisao
Mahakkanukrauh, Pasuk
Kraisarin, Jirachart
Shimizu, Takamasa
Kawamura, Kenji
Tanaka, Yasuhito
author_sort Hayami, Naoki
collection PubMed
description The effects of soft tissue damage and ulnar angulation deformity on radial head instability in Monteggia fractures are unclear. We tested the hypothesis that radial head instability correlates with the magnitude of ulnar angular deformity and the degree of proximal forearm soft tissue injury in Bado type I Monteggia fractures. We performed a biomechanical study in 6 fresh-frozen cadaveric upper extremities. Monteggia fractures were simulated by anterior ulnar angulation osteotomy and sequential sectioning of ligamentous structures. We measured radial head displacement during passive mobility testing in pronation, supination, and neutral rotation using an electromagnetic tracking device. Measurements at various ligament sectioning stages and ulnar angulation substages were statistically compared with those in the intact elbow. Radial head displacement increased with sequential ligament sectioning and increased proportionally with the degree of anterior ulnar angulation. Annular ligament sectioning resulted in a significant increase in displacement only in pronation (P < .05). When the anterior ulnar deformity was reproduced, the radial head displaced least in supination. The addition of proximal interosseous membrane sectioning significantly increased the radial head displacement in supination (P < .05), regardless of the degree of anterior ulnar angulation. Our Monteggia fracture model showed that radial head instability is influenced by the degree of soft tissue damage and ulnar angulation. Annular ligament injury combined with a minimal (5°) ulnar deformity may cause elbow instability, especially in pronation. The proximal interosseous membrane contributes to radial head stability in supination, regardless of ulnar angulation, and proximal interosseous membrane injury led to significant radial head instability in supination.
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spelling pubmed-69462992020-01-31 Effect of soft tissue injury and ulnar angulation on radial head instability in a Bado type I Monteggia fracture model Hayami, Naoki Omokawa, Shohei Iida, Akio Kira, Tsutomu Moritomo, Hisao Mahakkanukrauh, Pasuk Kraisarin, Jirachart Shimizu, Takamasa Kawamura, Kenji Tanaka, Yasuhito Medicine (Baltimore) 7100 The effects of soft tissue damage and ulnar angulation deformity on radial head instability in Monteggia fractures are unclear. We tested the hypothesis that radial head instability correlates with the magnitude of ulnar angular deformity and the degree of proximal forearm soft tissue injury in Bado type I Monteggia fractures. We performed a biomechanical study in 6 fresh-frozen cadaveric upper extremities. Monteggia fractures were simulated by anterior ulnar angulation osteotomy and sequential sectioning of ligamentous structures. We measured radial head displacement during passive mobility testing in pronation, supination, and neutral rotation using an electromagnetic tracking device. Measurements at various ligament sectioning stages and ulnar angulation substages were statistically compared with those in the intact elbow. Radial head displacement increased with sequential ligament sectioning and increased proportionally with the degree of anterior ulnar angulation. Annular ligament sectioning resulted in a significant increase in displacement only in pronation (P < .05). When the anterior ulnar deformity was reproduced, the radial head displaced least in supination. The addition of proximal interosseous membrane sectioning significantly increased the radial head displacement in supination (P < .05), regardless of the degree of anterior ulnar angulation. Our Monteggia fracture model showed that radial head instability is influenced by the degree of soft tissue damage and ulnar angulation. Annular ligament injury combined with a minimal (5°) ulnar deformity may cause elbow instability, especially in pronation. The proximal interosseous membrane contributes to radial head stability in supination, regardless of ulnar angulation, and proximal interosseous membrane injury led to significant radial head instability in supination. Wolters Kluwer Health 2019-11-01 /pmc/articles/PMC6946299/ /pubmed/31689815 http://dx.doi.org/10.1097/MD.0000000000017728 Text en Copyright © 2019 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by/4.0 This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0
spellingShingle 7100
Hayami, Naoki
Omokawa, Shohei
Iida, Akio
Kira, Tsutomu
Moritomo, Hisao
Mahakkanukrauh, Pasuk
Kraisarin, Jirachart
Shimizu, Takamasa
Kawamura, Kenji
Tanaka, Yasuhito
Effect of soft tissue injury and ulnar angulation on radial head instability in a Bado type I Monteggia fracture model
title Effect of soft tissue injury and ulnar angulation on radial head instability in a Bado type I Monteggia fracture model
title_full Effect of soft tissue injury and ulnar angulation on radial head instability in a Bado type I Monteggia fracture model
title_fullStr Effect of soft tissue injury and ulnar angulation on radial head instability in a Bado type I Monteggia fracture model
title_full_unstemmed Effect of soft tissue injury and ulnar angulation on radial head instability in a Bado type I Monteggia fracture model
title_short Effect of soft tissue injury and ulnar angulation on radial head instability in a Bado type I Monteggia fracture model
title_sort effect of soft tissue injury and ulnar angulation on radial head instability in a bado type i monteggia fracture model
topic 7100
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6946299/
https://www.ncbi.nlm.nih.gov/pubmed/31689815
http://dx.doi.org/10.1097/MD.0000000000017728
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