Evidence from a recent cadaveric study has revealed that the thickness of the distal interosseous membrane (DIOM) of the forearm shows substantial individual variations, and a thick fibrous tissue known as the distal oblique bundle (DOB) was found in 40 % specimens in the study. Another cadaveric study revealed that greater stability of the distal radioulnar joint (DRUJ) was obtained in a group with DOB following ulnar shortening than in a group without DOB. Thus, the presence of DOB influences the condition of DIOM and the ability of DIOM to provide stability to the compromised DRUJ. In the present study, we carried out a preoperative morphological evaluation of DIOM using ultrasound (US) and compared the US findings with intraoperative findings in order to investigate the efficacy and the meanings of this US evaluation. A total of 14 patients with various diseases or injuries of the distal forearm requiring corrective surgery were enrolled. The mean values of DIOM thickness as measured by US evaluation correlated well with those measured intraoperatively. The sensitivity of US evaluation in confirming presence of DOB was 80 % when the presence of DOB bundle was judged by DIOM thickness. In addition, 4 of 5 patients with chronic DRUJ instability showed no DOB. This study suggested that US can be a useful tool in evaluating DIOM and for detecting the presence of DOB and may provide helpful information regarding DRUJ instability.
This is a preview of subscription content, log in to check access.
Buy single article
Instant unlimited access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
Hotchkiss RN, An KN, Sowa DT, Basta S, Weiland AJ (1989) An anatomic and mechanical study of the interosseous membrane of the forearm: pathomechanics of proximal migration of the radius. J Hand Surg Am 14(2 Pt 1):256–261. doi:10.1016/0363-5023(89)90017-8
Noda K, Goto A, Murase T, Sugamoto K, Yoshikawa H, Moritomo H (2009) Interosseous membrane of the forearm: an anatomical study of ligament attachment locations. J Hand Surg Am 34(3):415–422. doi:10.1016/j.jhsa.2008.10.025
Skahen JR 3rd, Palmer AK, Werner FW, Fortino MD (1997) The interosseous membrane of the forearm: anatomy and function. J Hand Surg Am 22(6):981–985. doi:10.1016/S0363-5023(97)80036-6
Kihara H, Short WH, Werner FW, Fortino MD, Palmer AK (1995) The stabilizing mechanism of the distal radioulnar joint during pronation and supination. J Hand Surg Am 20(6):930–936. doi:10.1016/S0363-5023(05)80139-X
Watanabe H, Berger RA, Berglund LJ, Zobitz ME, An KN (2005) Contribution of the interosseous membrane to distal radioulnar joint constraint. J Hand Surg Am 30(6):1164–1171. doi:10.1016/j.jhsa.2005.06.013
Jupiter JB (2009) Commentary: the effect of ulnar styloid fractures on patient-rated outcomes after volar locking plating of distal radius fractures. J Hand Surg Am 34(9):1603–1604. doi:10.1016/j.jhsa.2009.06.022
Moritomo H, Noda K, Goto A, Murase T, Yoshikawa H, Sugamoto K (2009) Interosseous membrane of the forearm: length change of ligaments during forearm rotation. J Hand Surg Am 34(4):685–691. doi:10.1016/j.jhsa.2009.01.015
Arimitsu S, Moritomo H, Kitamura T, Berglund LJ, Zhao KD, An KN, Rizzo M (2011) The stabilizing effect of the distal interosseous membrane on the distal radioulnar joint in an ulnar shortening procedure: a biomechanical study. J Bone Joint Surg Am 93(21):2022–2030. doi:10.2106/jbjs.j.00411
Fester EW, Murray PM, Sanders TG, Ingari JV, Leyendecker J, Leis HL (2002) The efficacy of magnetic resonance imaging and ultrasound in detecting disruptions of the forearm interosseous membrane: a cadaver study. J Hand Surg Am 27(3):418–424. doi:10.1053/jhsu.2002.32961
Moritomo H, Masatomi T, Murase T, Miyake J, Okada K, Yoshikawa H (2010) Open repair of foveal avulsion of the triangular fibrocartilage complex and comparison by types of injury mechanism. J Hand Surg Am 35(12):1955–1963. doi:10.1016/j.jhsa.2010.07.031
Moritomo H (2012) The distal interosseous membrane: current concepts in wrist anatomy and biomechanics. J Hand Surg Am 37(7):1501–1507. doi:10.1016/j.jhsa.2012.04.037
Kitamura T, Moritomo H, Arimitsu S, Berglund LJ, Zhao KD, An KN, Rizzo M (2011) The biomechanical effect of the distal interosseous membrane on distal radioulnar joint stability: a preliminary anatomic study. J Hand Surg Am 36(10):1626–1630. doi:10.1016/j.jhsa.2011.07.016
Nishiwaki M, Nakamura T, Nakao Y, Nagura T, Toyama Y (2005) Ulnar shortening effect on distal radioulnar joint stability: a biomechanical study. J Hand Surg Am 30(4):719–726. doi:10.1016/j.jhsa.2005.04.015
Katz DI, Seiler JG 3rd, Bond TC (2011) The treatment of ulnar impaction syndrome: a systematic review of the literature. J Surg Orthop Adv 19(4):218–222
Sammer DM, Shah HM, Shauver MJ, Chung KC (2009) The effect of ulnar styloid fractures on patient-rated outcomes after volar locking plating of distal radius fractures. J Hand Surg Am 34(9):1595–1602. doi:10.1016/j.jhsa.2009.05.017
Conflict of interest
The authors declare that we have no conflict of interest.
Electronic supplementary material
Below is the link to the electronic supplementary material.
About this article
Cite this article
Okada, K., Moritomo, H., Miyake, J. et al. Morphological evaluation of the distal interosseous membrane using ultrasound. Eur J Orthop Surg Traumatol 24, 1095–1100 (2014) doi:10.1007/s00590-013-1388-6
- Distal interosseous membrane
- Distal radioulnar joint