http://www.bjj.boneandjoint.org.uk/content/95-B/10/1383.abstract

The effect of excision of the radial head and metallic radial head replacement on the tension in the interosseous membrane

1. B. A. Lanting, MD, BESc, FRCSC, Assistant Professor1 ; 
2. L. M. Ferreira, PhD, PEng, Assistant Professor2; 
3. J. A. Johnson, PhD, PEng, Professor2;
4. G. S. Athwal, MD, FRCSC, Associate Professor2 ; and 
5. G. J. W. King, MD, MSc, FRCSC, Professor; Director of the Hand and Upper Limb Centre2 

+Author Affiliations

1. 1London Health Sciences Center, University Hospital, LHSC, London, Ontario, N6C 5A5, Canada.
2. 2St. Joseph’s Health Care, St. Joseph’s Health Centre, 268 Grosvenor St., London, Ontario, N6A 4L6, Canada.

1. Correspondence should be sent to Dr B. A. Lanting; e-mail:brent.lanting@lhsc.on.ca

Abstract

We measured the tension in the interosseous membrane in six cadaveric forearms using an in vitro forearm testing system with the native radial head, after excision of the radial head and after metallic radial head replacement. The tension almost doubled after excision of the radial head during simulated rotation of the forearm (p = 0.007). There was no significant difference in tension in the interosseous membrane between the native and radial head replacement states (p = 0.09). Maximal tension occurred in neutral rotation with both the native and the replaced radial head, but in pronation if the radial head was excised. Under an increasing axial load and with the forearm in a fixed position, the rate of increase in tension in the interosseous membrane was greater when the radial head was excised than for the native radial head or replacement states (p = 0.02). As there was no difference in tension between the native and radial head replacement states, a radial head replacement should provide a normal healing environment for the interosseous membrane after injury or following its reconstruction. Load sharing between the radius and ulna becomes normal after radial head Replacement. As excision of the radial head significantly increased the tension in the interosseous membrane it may potentially lead to its attritional failure over time.

Cite this article: Bone Joint J 2013;95-B:1383–7.

Footnotes

• No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
  This article was primary edited by J. Scott and first-proof edited by D. Rowley.

• Received February 17, 2013.
• Accepted June 12, 2013.

• ©2013 The British Editorial Society of Bone & Joint Surgery