PDF herunterladen
J Wrist Surg 2016; 05(03): 179-183
DOI: 10.1055/s-0036-1584547
Special Focus Section: Interosseous Membrane and Its Effect on DRUJ
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Suture-Button Reconstruction of the Interosseous Membrane

Clifton G. Meals
1   The Curtis National Hand Center at The MedStar Union Memorial Hospital, Baltimore, Maryland
,
Christopher L. Forthman
1   The Curtis National Hand Center at The MedStar Union Memorial Hospital, Baltimore, Maryland
,
Keith A. Segalman
1   The Curtis National Hand Center at The MedStar Union Memorial Hospital, Baltimore, Maryland
› Institutsangaben
Weitere Informationen

Publikationsverlauf

19. Mai 2016

23. Mai 2016

Publikationsdatum:
20. Juni 2016 (online)

    Lizenzen und Reprints

Abstract

Background Reconstruction of the interosseous membrane (IOM) may play a role in the treatment of acute and chronic longitudinal forearm instability. Several reconstruction techniques have been proposed. Suture-button reconstruction is attractive because it obviates donor site morbidity and is relatively easy to perform. How this method compares to its alternatives, however, is unknown.

Materials and Methods We review literature describing reconstruction of the forearm axis. We describe how we perform suture-button reconstruction of the IOM, summarize our previously published biomechanical data on the subject, and offer a case report.

Description of Technique A suture-button is implanted so as to approximate the course of the interosseous ligament. This may be accomplished percutaneously, or when grafting is desired, through an open approach.

Results Data informing the choice of one reconstruction technique over another consist mostly of biomechanical studies and a small number of case reports.

Conclusions Suture-button reconstruction of the IOM may encourage anatomic healing of acute forearm axis injuries especially as an adjunct to radial head replacement or repair. Chronic injuries may benefit from a combination suture-button graft construct and ulnar shortening osteotomy.

Keywords

Suture-button - interosseous membrane - interosseous ligament - forearm - instability
 

  • References

  • 1 Means KJ, Graham T. Disorders of the forearm axis. In: Wolfe S, Hotchkis R, Pederson W, Kozin S, eds. Green's Operative Hand Surgery. 6 ed. London: Elsevier; 2011
    CrossrefGoogle Scholar
  • 2 Sowa DT, Hotchkiss RN, Weiland AJ. Symptomatic proximal translation of the radius following radial head resection. Clin Orthop Relat Res 1995; (317) 106-113
    PubMedGoogle Scholar
  • 3 McGinley JC, Kozin SH. Interosseous membrane anatomy and functional mechanics. Clin Orthop Relat Res 2001; (383) 108-122
    PubMedGoogle Scholar
  • 4 Pfaeffle HJ, Stabile KJ, Li ZM, Tomaino MM. Reconstruction of the interosseous ligament unloads metallic radial head arthroplasty and the distal ulna in cadavers. J Hand Surg Am 2006; 31 (2) 269-278
    CrossrefPubMedGoogle Scholar
  • 5 Tomaino MM, Pfaeffle J, Stabile K, Li ZM. Reconstruction of the interosseous ligament of the forearm reduces load on the radial head in cadavers. J Hand Surg [Br] 2003; 28 (3) 267-270
    CrossrefPubMedGoogle Scholar
  • 6 Marcotte AL, Osterman AL. Longitudinal radioulnar dissociation: identification and treatment of acute and chronic injuries. Hand Clin 2007; 23 (2) 195-208 , vi vi
    CrossrefPubMedGoogle Scholar
  • 7 Brin YS, Palmanovich E, Bivas A , et al. Treating acute Essex-Lopresti injury with the TightRope device: a case study. Tech Hand Up Extrem Surg 2014; 18 (1) 51-55
    CrossrefPubMedGoogle Scholar
  • 8 Drake ML, Farber GL, White KL, Parks BG, Segalman KA. Restoration of longitudinal forearm stability using a suture button construct. J Hand Surg Am 2010; 35 (12) 1981-1985
    CrossrefPubMedGoogle Scholar
  • 9 Kam CC, Jones CM, Fennema JL, Latta LL, Ouellette EA, Evans PJ. Suture-button construct for interosseous ligament reconstruction in longitudinal radioulnar dissociations: a biomechanical study. J Hand Surg Am 2010; 35 (10) 1626-1632
    CrossrefPubMedGoogle Scholar
  • 10 Jones CM, Kam CC, Ouellette EA, Milne EL, Kaimrajh D, Latta LL. Comparison of 2 forearm reconstructions for longitudinal radioulnar dissociation: a cadaver study. J Hand Surg Am 2012; 37 (4) 741-747
    CrossrefPubMedGoogle Scholar
  • 11 Pfaeffle HJ, Stabile KJ, Li ZM, Tomaino MM. Reconstruction of the interosseous ligament restores normal forearm compressive load transfer in cadavers. J Hand Surg Am 2005; 30 (2) 319-325
    CrossrefPubMedGoogle Scholar
  • 12 Sellman DC, Seitz Jr WH, Postak PD, Greenwald AS. Reconstructive strategies for radioulnar dissociation: a biomechanical study. J Orthop Trauma 1995; 9 (6) 516-522
    CrossrefPubMedGoogle Scholar
  • 13 Skahen III JR, Palmer AK, Werner FW, Fortino MD. Reconstruction of the interosseous membrane of the forearm in cadavers. J Hand Surg Am 1997; 22 (6) 986-994
    CrossrefPubMedGoogle Scholar
  • 14 Stabile KJ, Pfaeffle J, Saris I, Li ZM, Tomaino MM. Structural properties of reconstruction constructs for the interosseous ligament of the forearm. J Hand Surg Am 2005; 30 (2) 312-318
    CrossrefPubMedGoogle Scholar
  • 15 Tejwani SG, Markolf KL, Benhaim P. Graft reconstruction of the interosseous membrane in conjunction with metallic radial head replacement: a cadaveric study. J Hand Surg Am 2005; 30 (2) 335-342
    CrossrefPubMedGoogle Scholar
  • 16 Tejwani SG, Markolf KL, Benhaim P. Reconstruction of the interosseous membrane of the forearm with a graft substitute: a cadaveric study. J Hand Surg Am 2005; 30 (2) 326-334
    PubMedGoogle Scholar
  • 17 Gaspar M, Osterman A, Culp R. Short-to intermediate term outcomes following interosseous membrane reconstruction using Tightrope suture-button suspensionplasty system. American Association of Hand Surgery. http://meeting.handsurgery.org/files/2016/ePoster-Abstracts.pdf . Accessed May 10, 2016
    PubMedGoogle Scholar
  • 18 Chandler JW, Stabile KJ, Pfaeffle HJ, Li ZM, Woo SL, Tomaino MM. Anatomic parameters for planning of interosseous ligament reconstruction using computer-assisted techniques. J Hand Surg Am 2003; 28 (1) 111-116
    CrossrefPubMedGoogle Scholar
  • 19 Skahen III JR, Palmer AK, Werner FW, Fortino MD. The interosseous membrane of the forearm: anatomy and function. J Hand Surg Am 1997; 22 (6) 981-985
    CrossrefPubMedGoogle Scholar
  • 20 Hotchkiss RN, An KN, Sowa DT, Basta S, Weiland AJ. An anatomic and mechanical study of the interosseous membrane of the forearm: pathomechanics of proximal migration of the radius. J Hand Surg Am 1989; 14 (2 Pt 1): 256-261
    CrossrefPubMedGoogle Scholar