Skip to main content

Advertisement

SpringerLink
Log in

Comparative morphometry of the antebrachial and crural interosseous membranes: preliminary study for the use of the crural interosseous membrane in the surgical repair of the antebrachial interosseous membrane tears

  • Original Article
  • Published:
Surgical and Radiologic Anatomy Aims and scope Submit manuscript

Abstract

Introduction

Traumatic tears of the antebrachial interosseous membrane (AIOM) on its whole length are difficult to treat, particularly in the Essex-Lopresti syndrome. The number of ligamentoplasty techniques described in the literature witnesses the difficulty of its reconstruction and the absence of reliable and satisfying procedure. The aim of this study was to explore a new way of treatment, which consists in replacing the AIOM by the crural interosseous membrane (CIOM), harvested from the same patient.

Materials and methods

A morphometric study of the AIOM and CIOM has been conducted on both sides of 15 formalin preserved corpses (i.e. 30 AIOM and 30 CIOM). Studied data were: length of forearms and legs, length and width (at different locations) of the membranes, in situ and after harvesting, and orientation of their fibers. The thickness of membrane was also measured but only after harvesting.

Results

Concerning the AIOM, the mean length was 13.3 cm in situ and 12.8 cm after harvesting. Its width was maximal at the union of middle and distal thirds with an average value of 1.7 cm in situ and 1.45 cm after harvesting. Mean thickness was 1 mm. Anterior fibers were oblique distally and medially (20.5° ± 0.95°), and posterior fibers were oblique distally and laterally (40° ± 3.4°). Concerning the CIOM, the mean length was 24.75 cm in situ and 23.9 cm after harvesting. Its width was maximal at the union of proximal and middle thirds with an average value of 2.3 cm in situ and 1.85 cm after harvesting. Mean thickness was 0.5 mm. Obliquity of its fibers was reverse of that of the AIOM: the anterior fibers were quite oblique distally and laterally (13° ± 2.6°), and the posterior fibers oblique were oblique distally and medially (24.2° ± 2.48°).

Discussion

From these results, one may conclude that the largest length and width of the CIOM allow its use as substitute for the injured AIOM. The orientation of its fibers should necessitate either its reversal while using the same side or the use of the CIOM of the opposite side; its relative sharpness could signify that its biomechanical properties could be worse. A biomechanical study is necessary to evaluate how this new way of replacing the AIOM could resist to the strains imposed on the forearm.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Adams JE, Culp RW, Osterman AL (2010) Interosseous membrane reconstruction for the Essex-Lopresti injury. J Hand Surg Am 35:129–136

    Article  PubMed  Google Scholar 

  2. Adams JE, Osterman MN, Osterman AL (2010) Interosseous membrane reconstruction for forearm longitudinal instability. Tech Hand Up Extrem Surg 14:222–225

    Article  PubMed  Google Scholar 

  3. Adams JE, Steinmann SP, Osterman AL (2010) Management of injuries to the interosseous membrane. Hand Clin 26:543–548

    Article  PubMed  Google Scholar 

  4. Chloros GD, Wiesler ER, Stabile KJ, Papadonikolakis A, Ruch DS, Kuzma GR (2008) Reconstruction of Essex-Lopresti injury of the forearm: technical note. J Hand Surg Am 33:124–130

    Article  PubMed  Google Scholar 

  5. Dodds SD, Yeh PC, Slade JF 3rd (2008) Essex-Lopresti injuries. Hand Clin 24:125–137

    Article  PubMed  Google Scholar 

  6. Ebraheim NA, Taser F, Shafiq Q, Yeasting RA (2006) Anatomical evaluation and clinical importance of the tibiofibular syndesmosis ligaments. Surg Radiol Anat 28:142–149

    Article  PubMed  Google Scholar 

  7. Illuminati G, Calio FG, Bertagni A, Martinelli V (1998) Results of bypasses to the anterior tibial artery through the interosseous membrane. Langenbecks Arch Surg 383:259–264

    Article  CAS  PubMed  Google Scholar 

  8. Jin F, Skie M, Ebraheim NA, Lu J (1998) Anatomic basis of dorsoradial approach for radioulnar synostosis. Surg Radiol Anat 20:239–242

    Article  CAS  PubMed  Google Scholar 

  9. Kapandji A (1998) Le cadre radio-ulnaire. Son importance fonctionnelle dans les fractures des deux os de l’avant-bras. Ann Chir Main 17:348–361

    CAS  Google Scholar 

  10. LaStayo PC, Lee MJ (2006) The forearm complex: anatomy, biomechanics and clinical considerations. J Hand Ther 19:137–144

    Article  PubMed  Google Scholar 

  11. McGinley JC, Roach N, Gaughan JP, Kozin SH (2004) Forearm interosseous membrane imaging and anatomy. Skeletal Radiol 33:561–568

    Article  PubMed  Google Scholar 

  12. Minns RJ, Hunter JA (1976) The mechanical and structural characteristics of the tibio-fibular interosseous membrane. Acta Orthop Scand 47:236–240

    Article  CAS  PubMed  Google Scholar 

  13. Morris H (1879) The anatomy of the joints of man. J. and A. Churchill, London, pp 382–383

    Google Scholar 

  14. Noda K, Goto A, Murase T, Sugamoto K, Yoshikawa H, Moritomo H (2009) Interosseous membrane of the forearm: an anatomical study of ligament attachment locations. J Hand Surg Am 34:415–422

    Article  PubMed  Google Scholar 

  15. Pahl S, Schmidt HM (1994) Clinical anatomy of the interosseous arteries of the forearm. Handchir Mikrochir Plast Chir 26:246–250

    CAS  PubMed  Google Scholar 

  16. Sabo MT, Watts AC (2012) Reconstructing the interosseous membrane: a technique using synthetic graft and endobuttons. Tech Hand Up Extrem Surg 16:187–193

    Article  PubMed  Google Scholar 

  17. Skahen JR 3rd, Palmer AK, Werner FW, Fortino MD (1997) The interosseous membrane of the forearm: anatomy and function. J Hand Surg Am 22:981–985

    Article  PubMed  Google Scholar 

  18. Skahen JR 3rd, Palmer AK, Werner FW, Fortino MD (1997) Reconstruction of the interosseous membrane of the forearm in cadavers. J Hand Surg Am 22:986–994

    Article  PubMed  Google Scholar 

  19. Soubeyrand M, Oberlin C, Dumontier C, Belkheyar Z, Lafont C, Degeorges R (2006) Ligamentoplasty of the forearm interosseous membrane using the semi-tendinosus tendon: anatomical study and surgical procedure. Surg Radiol Anat 28:300–307

    Article  CAS  PubMed  Google Scholar 

  20. Soubeyrand M, Lafont C, De Georges R, Dumontier C (2007) Traumatic pathology of antibrachial interosseous membrane of forearm. Chir Main 26:255–277

    Article  PubMed  Google Scholar 

  21. Soubeyrand M, Wassermann V, Hirsch C, Oberlin C, Gagey O, Dumontier C (2011) The middle radioulnar joint and triarticular forearm complex. J Hand Surg Eur 36:447–454

    Article  CAS  Google Scholar 

  22. Tejwani SG, Markolf KL, Benhaim P (2005) Reconstruction of the interosseous membrane of the forearm with a graft substitute: a cadaveric study. J Hand Surg Am 30:326–334

    Article  PubMed  Google Scholar 

  23. Thomas KA, Harris MB, Willis MC, Lu Y, MacEwen GD (1995) The effects of the interosseous membrane and partial fibulectomy on loading of the tibia: a biomechanical study. Orthopedics 18:373–383

    CAS  PubMed  Google Scholar 

  24. Tomaino MM, Pfaeffle J, Stabile K, Li ZM (2003) Reconstruction of the interosseous ligament of the forearm reduces load on the radial head in cadavers. J Hand Surg Br 28:267–270

    Article  PubMed  Google Scholar 

  25. Yi XH, Pan J, Guo XS (2011) Anatomical and biomechanical study on the interosseous membrane of the cadaveric forearm. Chin J Traumatol 14:147–150

    PubMed  Google Scholar 

  26. Wang Q, Whittle M, Cunningham J, Kenwright J (1996) Fibula and its ligaments in load transmission and ankle joint stability. Clin Orthop Relat Res 330:261–270

    Article  PubMed  Google Scholar 

  27. Werner FW, Taormina JL, Sutton LG, Harley BJ (2011) Structural properties of 6 forearm ligaments. J Hand Surg Am 36:1981–1987

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Institute of Anatomy, Faculty of Medicine and Pharmacy, University of Caddi Ayad, Marrakech, Morocco

    Driss Elamrani

  2. Institute of Anatomy, Faculty of Medicine Henri Warembourg, University of Lille 2, PRES Nord de France, Place de Verdun, 59045, Lille Cedex, France

    Driss Elamrani, Aurélien Aumar, Guillaume Wavreille & Christian Fontaine

  3. Department of Orthopedics, Roger Salengro Hospital, University Hospitals of Lille, rue du Pr Émile Laine, 59037, Lille Cedex, France

    Guillaume Wavreille & Christian Fontaine

Authors
  1. Driss Elamrani
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Aurélien Aumar
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Guillaume Wavreille
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Christian Fontaine
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Christian Fontaine.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Elamrani, D., Aumar, A., Wavreille, G. et al. Comparative morphometry of the antebrachial and crural interosseous membranes: preliminary study for the use of the crural interosseous membrane in the surgical repair of the antebrachial interosseous membrane tears. Surg Radiol Anat 36, 333–339 (2014). https://doi.org/10.1007/s00276-013-1199-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00276-013-1199-9

Keywords

Search

Navigation