Unit:
Κατεύθυνση Χειρουργική ΑνατομίαLibrary of the School of Health Sciences
Supervisors info:
Σκανδαλάκης Παναγιώτης, Καθηγητής, Ιατρική, ΕΚΠΑ
Μαζαράκης Αντώνιος, Αναπληρωτής Καθηγητής, Ιατρική, ΕΚΠΑ
Δεμέστιχα Θεανώ, Αναπληρώτρια Καθηγήτρια, Ιατρική, ΕΚΠΑ
Original Title:
Χειρουργκή ανατομία της περιφερικής λοξής δεσμίδας μεσόστεου υμένα του αντιβραχίου (DOB) και η κλινική της σημασία στη σύγχρονη χειρουργική του καρπού
Translated title:
Distal oblique bundle of the interosseous membrane of the forearm - Surgical anatomy and importance in modern wrist surgery
Summary:
The distal oblique bundle is part of the distal interosseous membrane of the forearm and is treated as a recognized distinct structure since 2009, when it was first reported as DOB. The name was given by Noda et al. in their aricle «Interosseous membrane of the forearm: an anatomical study of ligament attachment locations», published in March 2009, in «Journal of Hand Surgery (Am.)». The exact definition was the following: «The DOB originated from approximately the distal one sixth area of the ulnar shaft, approximately coinciding with the proximal border of the pronator quadrates muscle, and ran distally toward the distal radioulnar joint. The fibers blended into the capsular tissue of the distal radioulnar joint and eventually the DOB inserted to the inferior rim of the sigmoid notch of the radius. Furthermore, some fibers extended more distally along the anterior and posterior ridges of the sigmoid notch, so the DOB seemed to display continuity with the dorsal and palmar radioulnar ligaments of the triangular fibrocartilage complex».
Until recently, DOB was not recognized as a separate structure. It is not observed in the entire population, but as recent studies indicate, it plays an important role in the stability of the distal radioulnar joint, when present. The issue has not been analyzed by a large number of writers and its study has been developing over the last decade. However, interest in the subject grows between surgeons who deal with surgical anatomy of the wrist. It is considered very likely to give key responses and solutions to the complex biomechanic of instability problems of the distal radioulnar joint, where in many cases conventional rehabilitation techniques are not sufficient.
Our review will attempt to gather all the knowledge that exists until today on the surgical anatomy of the area by analyzing and decoding the very long bibliography. On the other hand, due to the relatively recent recognition of the DOB structure, the bibliography on the specific subject is relatively limited. For this reason, beyond the review of the literature, we will try to add a little bit of knowledge around the bibliography on the structure and we will attempt to further direct the research that will improve the techniques of restoring the instability of the distal radioulnar joint by analyzing the gaps that exist in current literature, but also trying and completing some of them.
It is our strong belief that distal oblique bundle is worth investigating in full, since it seems to have an important role as an isometric stabilizer of the distal radioulnar joint when present.
Main subject category:
Health Sciences
Keywords:
Distal oblique bundle, Distal radioulnar joint, Distal interosseous membrane, Triangular fibrocartilage complex, Radioulnar instability
Number of references:
249
