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Interosseous Membrane Reconstruction Utilizing Flexor Digitorum Superficialis Autograft

Smith, Nicholas C. MBBS(Hons)*,†; Sivakumar, Brahman S. MBBS, BSci(Med), MS; Tremblay, Dominique M. BSc, MD§; Bellity, Jonathan P. MD§; Lawson, Richard D. MBBS(Hons)§

Techniques in Hand & Upper Extremity Surgery: September 2019 - Volume 23 - Issue 3 - p 122–127
doi: 10.1097/BTH.0000000000000237

Interosseous membrane (IOM) deficiency results in longitudinal radioulnar instability, and may result in proximal radial migration, increased radiocapitellar contact, limitations in forearm rotation, ulnocarpal instability, and ulna-sided pain. A number of reconstruction methods have been posited—however, few have been implemented in vivo. We describe a 2-bundle method of IOM reconstruction, utilizing flexor digitorum superficialis autograft. This technique has the benefits of utilizing a locally available and robust autograft with minimal donor-site morbidity, obviating the concerns associated with synthetic grafts or bone-patella tendon-bone constructs. It also replicates the nonisometric nature of the native IOM. We also present long-term results of a patient who underwent IOM reconstruction utilizing this method, following a cadaveric feasibility study.

*Macquarie Hand Unit, Macquarie Hospital, Sydney

Specialty Orthopaedics, Bella Vista

Department of Hand and Microsurgery, Fairfield and Liverpool Hospitals, Fairfield

§Department of Hand Surgery and Peripheral Nerve Surgery, Royal North Shore Hospital, University of Sydney, Sydney, NSW, Australia

Conflicts of Interest and Source of Funding: The authors report no conflicts of interest and no source of funding.

Address correspondence and reprint requests to Nicholas C. Smith, MBBS[Hons], Department of Specialty Orthopaedics, P.O. Box 6425, Baulkham Hills 2153, NSW, Australia. E-mail:

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