Answer to Letter to the Editor Regarding the Article “Ligamentous Reconstruction of the Interosseous Membrane of the Forearm in the Treatment of Instability of the Distal Radioulnar Joint”

Actually, the Distal Oblique Band (DOB), described by Moritomo,¹ is in the opposite direction. However, we performed an anatomical study and observed that the reconstruction of the DOB in the direction described by Moritomo is not ideal for the stabilization of the distal radioulnar joint (DRUJ). It is the most unstable, when compared with the technique employed here or with transverse tunnels.

We have also found that there is a “distal tract” (Fig. 1) of the interosseous membrane,² more dorsal and in the direction that we describe our technique³ (Fig. 3), which is more robust than the DOB (Fig. 2), and that its fibers terminate in the triangular fibrocartilage complex (TFCC).

Fig. 1
Distal Tract of the interosseous membrane.

Fig. 2
Distal Oblique Band (DOB).

Fig. 3
Reconstruction of the distal interosseous membrane with braquiorradialis.

We believe that the distal tract of the interosseous membrane, the oblique radius band for the ulna, from proximal to distal, has a higher value than the DOB, with respect to the stability of the DRUJ.

Maybe it is proper to correct our paper (Fig. 3), checking if no one else has described this “distal tract.”

References

• ¹
  Moritomo H. The distal interosseous membrane: current concepts in wrist anatomy and biomechanics. J Hand Surg Am 2012;37(07): 1501-1507
• ²
  Gabl M, Zimmermann R, Angermann P, et al. The interosseous membrane and its influence on the distal radioulnar joint. An anatomical investigation of the distal tract. J Hand Surg Br 1998; 23(02):179-182
• ³
  Aita MA, Mallozi RC, Ozaki W, Ikeuti DH, Consoni DAP, Ruggiero GM. Ligamentous reconstruction of the interosseous membrane of the forearm in the treatment of instability of the distal radioulnar joint. Rev Bras Ortop 2018;53(02):184-191

Publication Dates

• Publication in this collection
  22 July 2020
• Date of issue
  May-Jun 2020

History

• Received
  24 Sept 2019
• Accepted
  03 Oct 2019