Biomechanica Hungarica, Évf. 3, Szám 2

Is there any reality to the reverse kapandji operation In the treatment of proximal radioulnar synostosis? Biomechanical measurements

Rybaltovszki Henrik, Fekete Károly, Manó Sándor


The forearm, wrist and elbow joints in addition to the ligamentous system which holds the two bones together make up a combined joint with complex movement. Within this joint framework, injury at any point can result in profound biomechanical changes leading to functional alterations. Such an alteration is the bony bridge between the radius and ulna which is blocking the rotational movements. Surgical treatment can be instead of the resection of the bridge-callus creating a defect on the radius distally to the synostosis. This leads to a “reverse” Sauvé–Kapandji situation and to the disintegration of the bony frame of the forearm. The authors examined the stabilizing effect of the ligamentous system which holds the framework together, with emphasis on the role of the interosseous membrane. Measurements of rotational motion in various stages in the forearm were performed on fresh cadaver forearm preparations in both intact cases and also following the excision of a proximal segment of the radius. The movements were measured and registered using an Instron 8874 biomechanical material testing machine. In addition to registration, both fi xed and mobile digital recording was done. The stabilizing role of the interosseous membrane in supination was only effective when the radius was of normal length. The excision of the radial segment seriously damaged both the rotational motion and the stability of the wrist. 


DOI: 10.17489/biohun/2010/2/05

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