The central band is the thickest and most structurally significant component of the forearm interosseous membrane, running from the radius obliquely distoproximally to the ulna at approximately 20 degrees to the radial long axis. It is the primary longitudinal stabiliser of the forearm, transferring axial load from the radius to the ulna and preventing proximal radial migration.
Primary restraint to proximal radial migration after radial head excision; transfers 80% of forearm axial load from radius to ulna via its oblique orientation.
The central band is the key structure reconstructed in Essex-Lopresti repair of chronic longitudinal radioulnar dissociation. Graft reconstruction using palmaris longus or ECRB restores the longitudinal forearm stability lost when both the radial head and central band are disrupted. MRI with dedicated forearm protocol demonstrates central band integrity. Failure to reconstruct the central band after radial head excision leads to proximal radial migration and ulnar impaction.
Combined radial head fracture, central band tear, and DRUJ disruption causing longitudinal radioulnar dissociation with progressive proximal radial migration, requiring radial head replacement and central band reconstruction.
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