A minimally invasive method for the determination of force in the interosseous ligament.

OBJECTIVE: The objective was to develop and utilize a minimally invasive testing system to determine the force in the interosseous ligament under axial compressive loads across the range of motion of the human forearm. DESIGN: Eleven fresh frozen human cadaveric forearms were used (51-72 years). BACKGROUND: Current studies investigating interosseous ligament forces altered the structure of the forearm by implanting load cells into the radius and ulna. This may affect load transfer through the forearm. Little information was available on interosseous ligament function over the entire flexion range of the elbow. METHODS: A robotic joint testing system was used to apply a 100 N compressive load to the forearm and measure the resulting displacement. Each forearm was tested with no disruption of the bones and soft tissues of the forearm. The principle of superposition was used to calculate the forces in the interosseous ligament and was indirectly validated using fluoroscopy. RESULTS: The force in the interosseous ligament ranged from a minimum of 8 N in neutral forearm rotation at full extension to a maximum of 43 N in supination at 30 degrees of flexion. The largest force was found in supination at all flexion angles. CONCLUSIONS: The interosseous ligament is an important structure in the stability of the forearm. The force in the interosseous ligament depends on the elbow flexion angle and forearm rotation. RELEVANCE: This study suggests that radial head fractures are best treated with the forearm in supination, since the interosseous ligament takes the largest load in this position. Complex injuries which have a poor prognosis, may require interosseous ligament reconstruction to improve clinical outcomes.

Duke Scholars

Author Louis Edwin DeFrate Orthopaedic Surgery