In this review, the diagnostics of the Essex-Lopresti lesion is discussed. The lesion is a combination of fracture of the head of radius, rupture of the interosseous mebrane (IOM) and dislocation of the distal radioulnar joint. The lesion is often overlooked in the primary clinical settings, and it is correlated to severe instability, osteoarthritis and pain if untreated. The tools for diagnosing the condition are physical examination of relevant anatomical structures, radiographs of elbow and wrist and ultrasonic evaluation of IOM as well as peroperative tests of stability. The treatment is primarily focused on re-establishing stability of IOM.
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[Central band reconstruction in Essex-Lopresti lesions].
Oper Orthop Traumatol
August 2024
Klinik und Poliklinik für Orthopädie, Unfallchirurgie und Plastisch-Ästhetische Chirurgie, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
Objective: Restoration of longitudinal forearm stability by reconstruction of the central band (CB) of the interosseous membrane (IOM) of the forearm.
Indications: Acute and chronic Essex-Lopresti lesions (EL) with longitudinal forearm instability.
Contraindications: Absolute: acute/subacute infection.
Unstable lesions of the forearm: Terminology, evaluative score and synoptic table.
Injury
March 2023
Villa Erbosa (IRCCS Policlinico S. Donato Mi) Bologna.
The term "unstable lesions of the forearm" (ULF) was born to more easily describe how a partial or complete instability of the forearm unit might occur due to a traumatic loss of the transverse or longitudinal connection between the radius and ulna. For such an alteration to occur, at least two of the three main osteoligamentous locks (proximal, middle and distal) must be interrupted, often in association with a radial and/or ulnar fracture. Examining the historical patterns (Monteggia, Galeazzi, Essex-Lopresti and criss-cross lesions) and variants described in the literature, out of a total of 586 recorded interventions for forearm trauma, two elbow teams and one wrist team selected 75 cases of ULF.
View Article and Find Full Text PDFDefining acute Essex-Lopresti injuries is problematic and variable: a systematic review.
EFORT Open Rev
October 2022
Department of Orthopaedic Surgery, La Paz University Hospital, Madrid, Spain.
Purpose: The aim of this study was to systematically review clinical studies on the employed definitions of longitudinal forearm instabilities referred to as Essex-Lopresti (EL) injuries, interosseous membrane (IOM) injuries or longitudinal radioulnar dissociation.
Methods: A systematic literature search was performed in MEDLINE, Embase, CINAHL, Web of Science and Cochrane databases, adhering to PRISMA guidelines. All data on diagnosis and treatment were collected.
Concomitant Fracture Radial Head and Shaft With Dislocation of the Distal Radioulnar Joint: A Rare Variant of the Essex-Lopresti Lesion.
J Am Acad Orthop Surg Glob Res Rev
August 2022
From the Military Hospital Dehradun, Dehradun, India (Dr. Kaul and Dr. Akhoon), and the Department of Orthopaedics, Armed Forces Medical College, Pune, India (Dr. Sood).
The Essex-Lopresti lesion is a challenging injury both for diagnosis and management. These often tend to be missed, resulting in incapacitating pain and joint stiffness despite treatment. In rare circumstances, they may occur in association with other injuries of the forearm or elbow.
View Article and Find Full Text PDF[Radial head prosthesis for acute fractures].
Unfallchirurgie (Heidelb)
September 2022
Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Deutschland.
Non-reconstructible radial head fractures with concomitant injuries and resultant instability of the elbow are often treated by implantation of a radial head prosthesis. Various prosthetic designs and implantation techniques are available. Several pitfalls have to be respected during implantation.
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