AI Article Synopsis
- A study explored a novel treatment method for chronic Essex-Lopresti injuries involving radial head replacement and ulnar shortening osteotomy, as existing techniques lacked general acceptance.
- Seven patients were observed over a mean follow-up of 33 months, showing significant reductions in pain and improvements in elbow, forearm, and wrist motion after the procedure.
- The findings suggest that this combination of surgeries can offer satisfactory outcomes and a low risk of complications for chronic Essex-Lopresti injury patients.
Article Abstract
Background: Currently, no technique has met general acceptance for the restoration of forearm longitudinal stability in chronic Essex-Lopresti injuries. The purpose of this study is to present an alternative treatment method for chronic Essex-Lopresti lesions by radial head replacement and ulnar shortening osteotomy.
Methods: Seven patients with a mean age of 42.4 years were included in the study. Five patients had a staged approach, and 2 underwent both procedures simultaneously. The pain level was assessed with the use of a visual analog scale. Elbow, forearm, and wrist range of motion was evaluated. The Mayo Elbow Performance Score and Mayo Wrist Score were used to assess the postoperative outcomes.
Results: The mean follow-up time was 33 months. The mean pain level was reduced from 8.4 points preoperatively to 3.3 points postoperatively (P < .05). The elbow arc of motion was increased on average from 79° preoperatively to 121° postoperatively (P < .05). Forearm rotation improved from 76° preoperatively to 119° postoperatively (P < .05). The wrist arc of motion improved from 94° preoperatively to 114° postoperatively (P < .05). The mean postoperative Mayo Elbow Performance Score and Mayo Wrist Score were 82 points and 71 points, respectively. The mean ulnar variance was reduced from +8 mm to +3.5 mm postoperatively.
Conclusion: This study shows that radial head replacement in combination with ulnar shortening osteotomy can be used as an alternative reconstructive procedure in the case of a complex chronic Essex-Lopresti injury. This combination of known procedures yields predictable and satisfactory outcomes and a low complication rate.
Level Of Evidence: Level IV, case series, treatment study.
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| http://dx.doi.org/10.1016/j.jse.2014.01.043 | DOI Listing |
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