Inestabilidad del Antebrazo: Anatomía, Biomecánica y Opciones de Tratamiento

Forearm Instability: Anatomy, Biomechanics, and Treatment Options

 
Fuente
Este artículo es originalmente publicado en:

https://www.ncbi.nlm.nih.gov/pubmed/28052828

http://www.jhandsurg.org/article/S0363-5023(16)30895-4/abstract

De:

Adams JE1.

J Hand Surg Am. 2017 Jan;42(1):47-52. doi: 10.1016/j.jhsa.2016.10.017.

Todos los derechos reservados para:
 

Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Abstract

The forearm unit consists of the radius and ulna, a complex and interrelated set of joints (distal radioulnar joint, proximal radioulnar joint) and the soft tissue stabilizers between the 3 bones. Distally, this is represented by the triangular fibrocartilage complex at the wrist, proximally by the annular ligament at the elbow, and in the forearm by the interosseous membrane. Disruptions in any of these structures may lead to forearm instability, with consequences at each of the remaining structures.

Resumen

La unidad del antebrazo consiste en el radio y el cúbito, un conjunto complejo e interrelacionado de articulaciones (articulación radioulnar distal, articulación radioulnar proximal) y los estabilizadores de tejido blando entre los 3 huesos. Distalmente, esto está representado por el complejo triangular fibrocartílago en la muñeca, proximalmente por el ligamento anular en el codo y en el antebrazo por la membrana interósea. Las interrupciones en cualquiera de estas estructuras pueden conducir a inestabilidad del antebrazo, con consecuencias en cada una de las estructuras restantes.

KEYWORDS:

Essex Lopresti; Forearm instability; Galeazzi fracture; Monteggia fracture

PMID: 28052828   DOI:   10.1016/j.jhsa.2016.10.017
[PubMed – in process]

 
 
 
 

In vitro investigación experimental de la fuerza y torque que actúa sobre el escafoides durante una compresión ligera

In vitro experimental investigation of the forces and torque acting on the scaphoid during light grasp

Fuente
Este artículo es originalmente publicado en:
http://www.ncbi.nlm.nih.gov/pubmed/26800215
http://onlinelibrary.wiley.com/doi/10.1002/jor.23175/abstract
De:
Erhart J1, Unger E2, Schefzig P1, Krumboeck A3, Hagmann M4, Vecsei V1, Mayr W2.
J Orthop Res. 2016 Jan 22. doi: 10.1002/jor.23175. [Epub ahead of print] Todos los derechos reservados para:
This article is protected by copyright. All rights reserved.
Copyright © 1999-2016 John Wiley & Sons, Inc. All Rights Reserved
 

The aim of this study was to measure the magnitude and direction of forces and torque within osteotomized scaphoids within cadaveric wrists during grasping movement of the hand. The mechanical contributions of clinically relevant individual wrist-crossing tendon groups were investigated. Wrists of 8 forearms were immobilized in the sagittal, transverse and coronal plane on a fixation device with unhindered axial gliding. The scaphoid was osteotomized and the fragments stabilized using an interlocking nail. The nail served as a sensor for measurement of inter-fragmentary forces orthogonal and torque around the sensor axis. Thus, torque and cantilever forces were measured which originated between the fragments through co-contraction through the activity of wrist-crossing tendons. Grasping movement of the hand induced a mean maximum torque of 0.038 ± 0.051Nm and a force of 4.01 ± 1.71N on the scaphoid. The isolated activation of thumb tendons resulted in a torque of 9.9E-3  ± 7.7E-3 Nm and a force of 1.42 ± 0.49N. Despite immobilization of the wrist, grasping movement of the hand caused substantial forces and torque within the osteotomized scaphoid bone in varying directions and severity among different specimens. These factors may contribute to the development of nonunions and malunions in unstable scaphoid fractures through interfragmentary micromotion. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.

KEYWORDS:

biomechanics; grasping movement of the hand; scaphoid; wrist

PMID: 26800215 [PubMed – as supplied by publisher]

 

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