Distal radioulnar articulation

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Distal radioulnar articulation
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Ligaments of wrist. Anterior view.
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Vertical section through the articulations at the wrist, showing the synovial cavities
Details
SynonymsDistal radioulnar joint (DRUJ)
Identifiers
Latin articulatio radioulnaris distalis
TA98 A03.5.10.001
TA2 1781
FMA 35290
Anatomical terminology

The distal radioulnar articulation [1] (also known as the distal radioulnar joint, [2] or inferior radioulnar joint [1] [3] ) is a synovial pivot joint between the two bones in the forearm; the radius and ulna. It is one of two joints between the radius and ulna, the other being the proximal radioulnar articulation. The joint features an articular disc, and is reinforced by the palmar and dorsal radioulnar ligaments. [1] [3]

Contents

Structure

The distal radioulnar articulation is formed by the head of ulna, and the ulnar notch of the distal radius. [3] [1]

Articular disc

The joint features a triangular articular disc that is attached to the inferior margin of the ulnar notch by its base, and to a fossa at the base of the styloid process of the ulna by its apex. [3] The articular disc acts to firmly bind the distal extremities of the two bones together. [1]

Ligaments

The articulation is reinforced by the palmar radioulnar ligament, and dorsal radioulnar ligament. [1]

Function

The function of the radioulnar joint is to lift and maneuver weight load from the distal radioulnar joint to be distributed across the forearm's radius and ulna as a load-bearing joint. [4] Supination of the radioulnar joint can move from 0 degrees neutral to approximately 80-90 degrees where pronation of the radioulnar joint can move from 0 degrees neutral to approximately 70-90 degrees. [5] Supination (palms facing up) vs. pronation (palms facing down). Muscles that contribute to function are all supinator (biceps brachii, brachioradialis, and supinator) and pronator muscles (brachioradialis, pronator quadratus, and pronator peres).

Clinical significance

Injuries to the distal radioulnar articulation often result from falls onto an outstretched hand. Injury can occur with concurrent fracture of the distal radius, the ulna, or can be isolated. For the upper limit of the distal radioulnar distance, sources vary between 2 mm [6] and 5 mm. [7] A classification system has been proposed by Estaminet and colleagues. [8]

Estaminet Classification

Estaminet classified injuries of the distal radioulnar articulation into four categories with two subclasses: purely ligamentous (subclass A) and those with associated boney injury (subclass B).

Additional images

See also

Related Research Articles

<span class="mw-page-title-main">Carpal bones</span> Eight small bones that make up the wrist (or carpus) that connects the hand to the forearm

The carpal bones are the eight small bones that make up the wrist (carpus) that connects the hand to the forearm. The term "carpus" and "carpal" is derived from the Latin carpus and the Greek καρπός (karpós), meaning "wrist". In human anatomy, the main role of the carpal bones is to articulate with the radial and ulnar heads to form a highly mobile condyloid joint, to provide attachments for thenar and hypothenar muscles, and to form part of the rigid carpal tunnel which allows the median nerve and tendons of the anterior forearm muscles to be transmitted to the hand and fingers.

<span class="mw-page-title-main">Ulna</span> Medial bone from forearm

The ulna or ulnar bone is a long bone in the forearm stretching from the elbow to the wrist. It is on the same side of the forearm as the little finger, running parallel to the radius, the forearm's other long bone. Longer and thinner than the radius, the ulna is considered to be the smaller long bone of the lower arm. The corresponding bone in the lower leg is the fibula.

<span class="mw-page-title-main">Humerus</span> Long bone of the upper arm

The humerus is a long bone in the arm that runs from the shoulder to the elbow. It connects the scapula and the two bones of the lower arm, the radius and ulna, and consists of three sections. The humeral upper extremity consists of a rounded head, a narrow neck, and two short processes. The body is cylindrical in its upper portion, and more prismatic below. The lower extremity consists of 2 epicondyles, 2 processes, and 3 fossae. As well as its true anatomical neck, the constriction below the greater and lesser tubercles of the humerus is referred to as its surgical neck due to its tendency to fracture, thus often becoming the focus of surgeons.

<span class="mw-page-title-main">Wrist</span> Part of the arm between the lower arm and the hand

In human anatomy, the wrist is variously defined as (1) the carpus or carpal bones, the complex of eight bones forming the proximal skeletal segment of the hand; (2) the wrist joint or radiocarpal joint, the joint between the radius and the carpus and; (3) the anatomical region surrounding the carpus including the distal parts of the bones of the forearm and the proximal parts of the metacarpus or five metacarpal bones and the series of joints between these bones, thus referred to as wrist joints. This region also includes the carpal tunnel, the anatomical snuff box, bracelet lines, the flexor retinaculum, and the extensor retinaculum.

The forearm is the region of the upper limb between the elbow and the wrist. The term forearm is used in anatomy to distinguish it from the arm, a word which is used to describe the entire appendage of the upper limb, but which in anatomy, technically, means only the region of the upper arm, whereas the lower "arm" is called the forearm. It is homologous to the region of the leg that lies between the knee and the ankle joints, the crus.

<span class="mw-page-title-main">Ulnar nerve</span> Nerve which runs near the ulna bone

The ulnar nerve is a nerve that runs near the ulna, one of the two long bones in the forearm. The ulnar collateral ligament of elbow joint is in relation with the ulnar nerve. The nerve is the largest in the human body unprotected by muscle or bone, so injury is common. This nerve is directly connected to the little finger, and the adjacent half of the ring finger, innervating the palmar aspect of these fingers, including both front and back of the tips, perhaps as far back as the fingernail beds.

<span class="mw-page-title-main">Radius (bone)</span> One of the two long bones of the forearm

The radius or radial bone is one of the two large bones of the forearm, the other being the ulna. It extends from the lateral side of the elbow to the thumb side of the wrist and runs parallel to the ulna. The ulna is longer than the radius, but the radius is thicker. The radius is a long bone, prism-shaped and slightly curved longitudinally.

<span class="mw-page-title-main">Upper limb</span> Consists of the arm, forearm, and hand

The upper limbs or upper extremities are the forelimbs of an upright-postured tetrapod vertebrate, extending from the scapulae and clavicles down to and including the digits, including all the musculatures and ligaments involved with the shoulder, elbow, wrist and knuckle joints. In humans, each upper limb is divided into the arm, forearm and hand, and is primarily used for climbing, lifting and manipulating objects.

<span class="mw-page-title-main">Distal radius fracture</span> Fracture of the radius bone near the wrist

A distal radius fracture, also known as wrist fracture, is a break of the part of the radius bone which is close to the wrist. Symptoms include pain, bruising, and rapid-onset swelling. The ulna bone may also be broken.

The pronator teres is a muscle that, along with the pronator quadratus, serves to pronate the forearm. It has two origins, at the medial humeral supracondylar ridge and the ulnar tuberosity, and inserts near the middle of the radius.

<span class="mw-page-title-main">Supinator muscle</span> Muscle of the forearm in humans

In human anatomy, the supinator is a broad muscle in the posterior compartment of the forearm, curved around the upper third of the radius. Its function is to supinate the forearm.

<span class="mw-page-title-main">Galeazzi fracture</span> Medical condition

The Galeazzi fracture is a fracture of the distal third of the radius with dislocation of the distal radioulnar joint. It classically involves an isolated fracture of the junction of the distal third and middle third of the radius with associated subluxation or dislocation of the distal radio-ulnar joint; the injury disrupts the forearm axis joint.

<span class="mw-page-title-main">Carpometacarpal joint</span> Joint between the wrist and hand

The carpometacarpal (CMC) joints are five joints in the wrist that articulate the distal row of carpal bones and the proximal bases of the five metacarpal bones.

<span class="mw-page-title-main">Madelung's deformity</span> Type of malformation of the wrist bones

Madelung's deformity is usually characterized by malformed wrists and wrist bones and is often associated with Léri-Weill dyschondrosteosis. It can be bilateral or just in the one wrist. It has only been recognized within the past hundred years. Named after Otto Wilhelm Madelung (1846–1926), a German surgeon, who described it in detail, it was noted by others. Guillaume Dupuytren mentioned it in 1834, Auguste Nélaton in 1847, and Joseph-François Malgaigne in 1855.

<span class="mw-page-title-main">Annular ligament of radius</span>

The annular ligament is a strong band of fibers that encircles the head of the radius, and retains it in contact with the radial notch of the ulna.

<span class="mw-page-title-main">Interosseous membrane of forearm</span>

The interosseous membrane of the forearm is a fibrous sheet that connects the interosseous margins of the radius and the ulna. It is the main part of the radio-ulnar syndesmosis, a fibrous joint between the two bones.

<span class="mw-page-title-main">Triangular fibrocartilage</span> Anatomical feature in the wrist

The triangular fibrocartilage complex (TFCC) is formed by the triangular fibrocartilage discus (TFC), the radioulnar ligaments (RULs) and the ulnocarpal ligaments (UCLs).

<span class="mw-page-title-main">Elbow</span> Joint between the upper and lower parts of the arm

The elbow is the region between the upper arm and the forearm that surrounds the elbow joint. The elbow includes prominent landmarks such as the olecranon, the cubital fossa, and the lateral and the medial epicondyles of the humerus. The elbow joint is a hinge joint between the arm and the forearm; more specifically between the humerus in the upper arm and the radius and ulna in the forearm which allows the forearm and hand to be moved towards and away from the body. The term elbow is specifically used for humans and other primates, and in other vertebrates it is not used. In those cases, forelimb plus joint is used.

The Essex-Lopresti fracture is a fracture of the radial head of the forearm with concomitant dislocation of the distal radio-ulnar joint along with disruption of the thin interosseous membrane which holds them together. The injury is named after Peter Essex-Lopresti who described it in 1951.

<span class="mw-page-title-main">Extrinsic extensor muscles of the hand</span>

The extrinsic extensor muscles of the hand are located in the back of the forearm and have long tendons connecting them to bones in the hand, where they exert their action. Extrinsic denotes their location outside the hand. Extensor denotes their action which is to extend, or open flat, joints in the hand. They include the extensor carpi radialis longus (ECRL), extensor carpi radialis brevis (ECRB), extensor digitorum (ED), extensor digiti minimi (EDM), extensor carpi ulnaris (ECU), abductor pollicis longus (APL), extensor pollicis brevis (EPB), extensor pollicis longus (EPL), and extensor indicis (EI).

References

  1. 1 2 3 4 5 6 Gray, Henry (1918). Gray's Anatomy (20th ed.). p. 326.
  2. Dyan V. Flores; Darwin Fernández Umpire; Kawan S. Rakhra; Zaid Jibri; Gonzalo A. Serrano Belmar (18 Nov 2022). "Distal Radioulnar Joint: Normal Anatomy, Imaging of Common Disorders, and Injury Classification". Radiographics. 43 (1): e220109. doi:10.1148/rg.220109. PMID   36399415. S2CID   253627145.
  3. 1 2 3 4 Chummy S. Sinnatamby (2011). Last's anatomy: regional and applied (12th ed.). Edinburgh: Elsevier. p. 72. ISBN   978-0-7020-4839-5. OCLC   764565702.
  4. Lees, VC (2013). "Functional anatomy of the distal radioulnar joint in health and disease". The Annals of the Royal College of Surgeons of England. 95 (3): 163–170. doi:10.1308/003588413X13511609957452. PMC   4165238 . PMID   23827285.
  5. Thomas, Binu P.; Sreekanth, Raveendran (2012). "Distal radioulnar joint injuries". Indian Journal of Orthopaedics. 46 (5): 493–504. doi: 10.4103/0019-5413.101031 . PMC   3491781 .
  6. Jack A Porrino Jr (15 March 2022). Felix S Chew (ed.). "Distal Radial Fracture Imaging" . Medscape . Updated: Aug 14, 2018
  7. Page 341 in: Richard A. Berger, Arnold-Peter C. Weiss (2004). Hand Surgery, Volumes 1-2. Lippincott Williams & Wilkins. ISBN   978-0-7817-2874-4.
  8. Estaminet et al. Estaminet-Klassifikation von distal radioulnar Aussprache-Trauma. 20. Jahresversammlung der europäischen Orthopädischen Forschungsgesellschaft (EORS 2012), am 26–28 September, Amsterdam, Die Niederlande