Biomechanical function of the distal radioulnar and ulnocarpal wrist ligaments.

PURPOSE: This study was designed to provide quantitative information concerning the functions of the ligaments that stabilize the distal radioulnar joint (DRUJ). This joint permits the radius to rotate around a nearly fixed ulna allowing supination and pronation of the hand. Understanding their function is important in developing procedures for reconstruction.

METHODS: Using a ligament tension transducer that hooked under the center of the ligament and deflected it laterally while measuring the force required, we determined the tensions in 6 ligaments in 9 cadaver arms in pronation and supination of the hand. These ligaments included those of the DRUJ: palmar distal radioulnar ligament (PDRUL) and dorsal distal radioulnar ligament (DDRUL); and the ulnocarpal joint ligaments: ulnolunate ligament (ULL), ulnotriquetral ligament (UTL), and the ulnocarpal collateral ligament (UCCL), which includes the subsheath of the extensor carpi ulnaris, and the dorsal ulnocarpal ligament (DUCL).

RESULTS: For the ligaments of the DRUJ in supination, the mean tension in the PDRUL (2.6 N) was greater than that of the DDRUL (0.8 N), whereas in pronation the mean tension in the PDRUL (1.1 N) was less than that of the DDRUL (1.7 N). For the ulnocarpal ligaments in supination, the ligament tensions in the ULL, UTL, and the UCCL were significantly greater than the same ligaments with the forearm pronated. The DUCL tension remained unchanged throughout supination and pronation.

CONCLUSIONS: In supination of the forearm all ligaments except for the DDRUL had equivalent tensions, indicating their role in stabilizing the joint to this motion. In pronation ligament tensions generally were lower but were distributed over all 6 ligaments tested. DUCL tension was equivalent in both supination and pronation, unlike the other ligaments that had greater tensions in supination.