The Triple Heater (TH)
Narda G. Robinson in Interactive Medical Acupuncture Anatomy, 2016
Dorsal radiocarpal ligament: Originates from the dorsal margin of the distal radius. Extends in a distal and oblique direction toward the ulnar aspect of the wrist. Fibers attach to the lunate bone and lunotriquetral interosseous ligament. The dorsal radiocarpal ligament and dorsal intercarpal ligaments form a “V” configuration. They function in alliance as a dorsal radioscaphoid ligament that varies its length by means of changing the angle of the “V."3 The lateral “V” configuration allows normal carpal kinematic activity while, at the same time, stabilizing the dorsum of the wrist by means of its attachment to the scaphoid through wrist range of motion.4 The dorsal radiocarpal and intercarpal ligaments increase in length and tension with ulnar flexion of the wrist, as observed during a dart-throwing motion. Note the relative positions of the carpal bones available for viewing in Figure 10-8.
The Articulations of the Upper Member
Gene L. Colborn, David B. Lause in Musculoskeletal Anatomy, 2009
The Distal Radio-ulnar Joint. The distal radio-ulnar joint is of the trochoid or pivot-type, the head of the ulna articulating with the ulnar notch of the distal end of the radius. The rotation of the distal end of the radius about the head of the ulna results in pronation and supination of the forearm. The two bones are held together distally by a number of ligamentous structures, the most important of which is the the fibrocartilaginous articular disk which joins the two bones together and which serves to separate the distal end of the ulna from direct contact with the carpal bones. Distally, the fibrocartilaginous disk is in contact with the triquetral bone and the medial part of the lunate bone.
Extremity trauma
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie in Bailey & Love's Short Practice of Surgery, 2018
The most commonly involved carpal bone is the lunate. A lunate dislocation is where the lunate bone dislocates out of the radiocarpal joint. In a perilunate dislocation the lunate remains in the radiocarpal joint and the rest of the carpus dislocates around the lunate. Lunate and perilunate dislocations are easily missed unless careful attention is paid to carpal alignment on the lateral radiograph (Figure28.19). Review of the radiographs should particularly ensure the anatomical location of the lunate in the radiocarpal fossa and that the capitate in the ‘cup' of the lunate is maintained.
Vascularized medial femoral condyle graft for nonunion after failed radiolunate arthrodesis
Published in Case Reports in Plastic Surgery and Hand Surgery, 2019
Akito Nakanishi, Shohei Omokawa, Kenji Kawamura, Takamasa Shimizu, Yasuhito Tanaka
In our case, it was difficult to achieve bone union in rearthrodesis surgery because the volume of lunate bone had decreased due to the first failed arthrodesis surgery. Thus, we chose a vascularized bone graft to obtain reliable bone union. We could not use a vascularized radius graft due to the initial complex distal radius fracture, and therefore, we had to use a free vascularized bone graft. Eventually, we chose a vascularized medial femoral condyle bone graft for the procedure. Our concern was insufficient strength of medial femoral condyle bone due to its flexibility, and for this reason we used an external fixation device for 4 weeks. Finally, the strength of the medial femoral condyle bone was sufficient and there were no problems at the arthrodesis site after bone union was obtained. In conclusion, this case shows that a vascularized medial femoral condyle bone graft is a good option in cases of nonunion after initial arthrodesis of the radiolunate joint.
Related Knowledge Centers
- Capitate Bone
- Hamate Bone
- Hand
- Scaphoid Bone
- Ossification
- Carpal Bones
- Ulna
- Radius
- Triquetral Bone
- Scapholunate Ligament