Biomechanical comparison of transosseous re-fixation of the deep fibres of the distal radioulnar ligaments versus deep and superficial fibres: a cadaver study

Purpose: We hypothesized that the re-fixation of the deep and superficial fibres of the distal radioulnar ligaments provide improved stability compared to reconstruction of the deep fibres alone. Methods: Fourteen fresh-frozen cadaver upper extremities were used for biomechanical testing. Transosseo...

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Main Authors: Spies, Christian (Author) , Unglaub, Frank (Author)
Format: Article (Journal)
Language:English
Published: 2016
In: International orthopaedics
Year: 2015, Volume: 40, Issue: 2, Pages: 315-321
ISSN:1432-5195
DOI:10.1007/s00264-015-2986-1
Online Access:Verlag, Volltext: http://dx.doi.org/10.1007/s00264-015-2986-1
Verlag, Volltext: https://doi.org/10.1007/s00264-015-2986-1
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Author Notes:Christian K. Spies, Anja Niehoff, Frank Unglaub, Lars P. Müller, Martin F. Langer, Wolfram F. Neiss, Johannes Oppermann

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520 |a Purpose: We hypothesized that the re-fixation of the deep and superficial fibres of the distal radioulnar ligaments provide improved stability compared to reconstruction of the deep fibres alone. Methods: Fourteen fresh-frozen cadaver upper extremities were used for biomechanical testing. Transosseous re-fixation of the deep fibres of the distal radioulnar ligaments alone (single mattress suture group; n = 7) was compared to the transosseous re-attachment of the deep and superficial fibres (double mattress suture group; n = 7). Cyclic load application provoked palmar translation of the radius with respect to the rigidly affixed ulna. Creep, stiffness, and hysteresis were obtained from the load-deformation curves, respectively. Testing was done in neutral forearm rotation, 60° pronation, and 60° supination. Results: The re-fixation techniques did not differ significantly regarding the viscoelastic parameters creep, hysteresis, and stiffness. Several significant differences of one cycle to the consecutive one within each re-fixation group could be detected especially for creep and hysteresis. No significant differences between the different forearm positions could be detected for each viscoelastic parameter. Conclusions: The re-fixation techniques did not differ significantly regarding creep, hysteresis, and stiffness. This means that the additional re-attachment of the superficial fibres may not provide greater stability to the DRUJ. Bearing in mind that the study was a cadaver examination with a limited number of specimens we may suppose that the re-attachment of the superficial fibres seem to be unnecessary. A gradual decline of creep and hysteresis from first to last loading-unloading cycle is to be expected and typical of ligaments which are viscoelastic. 
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