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Ligamentoplasty of the forearm interosseous membrane using the semitendinosus tendon: anatomical study and surgical procedure

  • Anatomic Bases of Medical, Radiological and Surgical Techniques
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Abstract

Total longitudinal disruptions of the interosseous membrane can allow proximal radius migration and are seen in Essex-Lopresti lesions. We propose an original technique of ligamentoplasty using the semitendinosus tendon. The graft corresponds to the forearm rotation axis for an optimized isometry and longitudinal stabilization. Our ligamentoplasty technique was performed on ten fresh frozen right forearms. We successively assessed the innocuousness, efficiency and resistance of the ligamentoplasty. The ligamentoplasty induced neither passive limitation of pronation–supination nor neurovascular lesions. It prevented from radius proximal migration. The mean load to failure was 28 kg at both ulnar and radial sides of the graft. Our technique is original for the type and position of the graft. It seems safe, efficient and resistant enough for in vivo procedures. This technique decreases longitudinal loads on the radius. It should be indicated in patients with Essex-Lopresti syndrome, in association with radial head internal fixation or arthroplasty.

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References

  1. Ashwood N, Bain GI, Unni R (2004) Management of Mason type-III radial head fractures with a titanium prosthesis, ligament repair, and early mobilization. J Bone Joint Surg Am 86A:274–280

    Google Scholar 

  2. Broberg MA, Morrey BF (1986) Results of delayed excision of the radial head after fracture. J Bone Joint Surg Am 68A:669–674

    Google Scholar 

  3. Coleman DA, Blair WF, Shurr D (1987) Resection of the radial head for fracture of the radial head. Long-term follow-up of seventeen cases. J Bone Joint Surg Am 69A:385–392

    Google Scholar 

  4. Davidson PA, Moseley JB, Tullos HS (1993) Radial head fracture. A potentially complex injury. Clin Orthop 297:224–230

    PubMed  Google Scholar 

  5. Edwards GS, Jupiter JB (1988) Radial head fractures with acute distal radioulnar dislocation. Essex-Lopresti revisited. Clin Orthop 234:61–69

    PubMed  Google Scholar 

  6. Eglseder WA, Hay M (1993) Combined Essex-Lopresti and radial shaft fractures: case report. J Trauma 34:310–312

    PubMed  CAS  Google Scholar 

  7. Essex-Lopresti P (1951) Fractures of the radial head with distal radioulnar dislocation; report of two cases. J Bone Joint Surg Br 33B:244–247

    PubMed  CAS  Google Scholar 

  8. Failla JM, Jacobson J, Van Holsbeeck M (1999) Ultrasound diagnosis and surgical pathology of the torn interosseous membrane in forearm fractures/dislocations. J Hand Surg Am 24A:257–266

    Article  Google Scholar 

  9. Gabriel MT, Pfaeffle HJ, Stabile KJ, Tomaino MM, Fischer KJ (2004) Passive strain distribution in the interosseous ligament of the forearm: implications for injury reconstruction. J Hand Surg Am 29A:293–298

    Article  Google Scholar 

  10. Geel CW, Palmer AK (1992) Radial head fractures and their effect on the distal radioulnar joint. A rationale for treatment. Clin Orthop 275:79–84

    PubMed  Google Scholar 

  11. Goldberg I, Peylan J, Yosipovitch Z (1986) Late results of excision of the radial head for an isolated closed fracture. J Bone Joint Surg Am 68A:675–679

    Google Scholar 

  12. Hargadon EJ, Porter ML (1988) The Essex-Lopresti injury: a variation. J Hand Surg Br 13B:450–452

    Google Scholar 

  13. Hotchkiss RN (1994) Injuries to the interosseous ligament of the forearm. Hand Clin 10:391–398

    PubMed  CAS  Google Scholar 

  14. 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 14A:256–261

    Article  Google Scholar 

  15. Janssen RP, Vegter J (1998) Resection of the radial head after Mason type-III fractures of the elbow: follow-up at 16 to 30 years. J Bone Joint Surg Br 80B:231–233

    Article  Google Scholar 

  16. Khurana JS, Kattapuram SV, Becker S, Mayo-Smith W (1988) Galeazzi injury with an associated fracture of the radial head. Clin Orthop 234:70–71

    PubMed  Google Scholar 

  17. Knight DJ, Rymaszewski LA, Amis AA, Miller JH (1993) Primary replacement of the fractured radial head with a metal prosthesis. J Bone Joint Surg Br 75B:572–576

    Google Scholar 

  18. Maeda A, Shino K, Horibe S, Nakata K, Buccafusca G (1996) Anterior cruciate ligament reconstruction with multistranded autogenous semitendinosus tendon. Am J Sports Med 24:504–509

    Article  PubMed  CAS  Google Scholar 

  19. Manson TT, Pfaeffle HJ, Herdon JH, Tomaino MM, Fischer K (2000) Forearm rotation alters interosseous ligament strain distribution. J Hand Surg Am 25A:1058–1063

    Google Scholar 

  20. McGinley JC, D’addessi L, Sadeghipour K, Kozin SH (2001) Mechanics of the antebrachial interosseous membrane: Response to shearing forces. J Hand Surg Am 26A:733–741

    Article  Google Scholar 

  21. McGinley JC, Roach N, Gaughan JP, Kozin SH (2004) Forearm interosseous membrane imaging and anatomy. Skeletal Radiol 33:561–568

    Article  PubMed  Google Scholar 

  22. Morrey BF, Schneeberger AG (2002) Anconeus arthroplasty: a new technique for reconstruction of the radiocapitellar and/or proximal radioulnar joint. J Bone Joint Surg Am 84A:1960–1969

    Google Scholar 

  23. Pfaeffle HJ, Tomaino MM, Grewal R, Xu J, Boardman ND, Woo SL, Herndon JH (1996) Tensile properties of the interosseous membrane of the human forearm. J Orthop Res 14:842–845

    Article  PubMed  CAS  Google Scholar 

  24. Sellman DC, Seitz WH, Postak PD, Greenwald AS (1995) Reconstructive strategies for radioulnar dissociation: a biomechanical study. J Orthop Trauma 9:516–522

    Article  PubMed  CAS  Google Scholar 

  25. Shaieb MD, Kan DM, Chang SK, Marumoto JM, Richardson AB (2002) A prospective randomized comparison of patellar tendon versus semitendinosus and gracilis tendon autografts for anterior cruciate ligament reconstruction. Am J Sports Med 30:214–220

    PubMed  Google Scholar 

  26. Simonian PT, Harrison SD, Cooley VJ, Escabedo EM, Deneka DA, Larson RV (1997) Assessment of morbidity of semitendinosus and gracilis tendon harvest for ACL reconstruction. Am J Knee Surg 10:54–59

    PubMed  CAS  Google Scholar 

  27. Skahen JR, Palmer AK, Werner FW, Fortino MD (1997) Reconstruction of the interosseous membrane of the forearm in cadavers. J Hand Surg Am 22A:986–994

    Article  Google Scholar 

  28. Sowa DT, Hotchkiss RN, Weiland AJ (1995) Symptomatic proximal translation of the radius following radial head resection. Clin Orthop 317:106–113

    PubMed  Google Scholar 

  29. Stabile KJ, Pfaeffle HJ, Tomaino MM (2002) The Essex-Lopresti fracture-dislocation factors in early management and salvage alternatives. Hand Clin 18:195–204

    Article  PubMed  Google Scholar 

  30. Szabo RM, Hotchkiss RN, Slater RR (1997) The use of frozen-allograft radial head replacement for treatment of established symptomatic proximal translation of the radius: preliminary experience in five cases. J Hand Surg Am 22A:269–278

    Article  Google Scholar 

  31. Tejwani SG, Markolf KL, Benhaim P (2005) Graft reconstruction of the interosseous membrane in conjunction with metallic radial head replacement: a cadaveric study. J Hand Surg Am 30A:335–342

    Article  Google Scholar 

  32. Tejwani SG, Markolf KL, Benhaim P (2005) Reconstruction of the interosseous membrane of the forearm with a graft substitute: a cadaveric study. J Hand Surg Am 30A:326–334

    Article  Google Scholar 

  33. Tomaino MM, Pfaeffle J, Stabile K, Li ZM (2003) Reconstruction of the interosseous ligament of the forearm reduces load on the radial head in cadavers. J Hand Surg Br 28B:267–270

    Google Scholar 

  34. Trousdale RT, Amadio PC, Cooney WP, Morrey BF (1992) Radio-ulnar dissociation. A review of twenty cases. J Bone Joint Surg Am 74A:1486–1497

    Google Scholar 

  35. Wallace AL, Walsh WR, Van Rooijen M, Hughes JS, Sonnabend DH (1997) The interosseous membrane in radio-ulnar dissociation. J Bone Joint Surg Br 79B:422–427

    Article  Google Scholar 

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Correspondence to R. Degeorges.

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Soubeyrand, M., Oberlin, C., Dumontier, C. et al. Ligamentoplasty of the forearm interosseous membrane using the semitendinosus tendon: anatomical study and surgical procedure. Surg Radiol Anat 28, 300–307 (2006). https://doi.org/10.1007/s00276-006-0086-z

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  • DOI: https://doi.org/10.1007/s00276-006-0086-z

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