Interosseous Membrane Reconstructions for Longitudinal Radioulnar Instability: A Cadaveric Comparison

Area of Science:

• Orthopedic surgery
• Biomechanical engineering
• Upper extremity reconstruction

Background:

• Interosseous membrane (IOM) reconstruction offers multiple material options.
• This study evaluates biomechanical properties of IOM reconstruction using suture button suspension with and without pronator teres (PT) tendon rerouting.

Purpose of the Study:

• To biomechanically assess the efficacy of suture button suspension in interosseous membrane reconstruction.
• To compare radioulnar displacement with and without pronator teres tendon transfer and suture button augmentation.

Main Methods:

• Eight cadaveric specimens were tested under various conditions: intact, IOM release with radial head (RH) resection, PT tendon transfer alone, and PT transfer with suture button suspension (with/without RH replacement).
• Specimens underwent cyclic loading to 130 N, with radioulnar displacement measured.
• Statistical analysis used a repeated measure 1-way ANOVA and Tukey test (P < .05).

Main Results:

• IOM reconstruction with PT graft and suture button suspension (with RH arthroplasty) did not significantly reduce radioulnar displacement (2.99 ± 1.92 mm vs. 2.88 ± 1.56 mm).
• Suture button suspension augmentation did not significantly increase the stiffness of the PT IOM reconstruction construct with RH arthroplasty (82.48 N/mm vs. 71.51 N/mm).

Conclusions:

• Pronator teres transfer combined with suture button augmentation effectively restores radioulnar stability.
• No significant difference in stability was found between PT transfer with and without suture button suspension augmentation.