An uncommon variant of the Essex-Lopresti injury

Kedous, Mohamed Ali; Msakni, Ahmed; Chebbi, Wael; Zarâa, Mourad; Mbarek, Mondher

doi:10.1007/s00256-017-2782-7

Cited by 2 publications

(2 citation statements)

References 20 publications

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“…However, the extremely rare combination of an Essex-Lopresti lesion and a Galeazzi fracture has only been reported once by Eglseder and Hay 10 in 1993. A similar injury comprising a posterior dislocation of the radiohumeral joint, a radial shaft fracture, and a DRUJ dislocation was reported by Kedous et al 11 in 2017. To the best of our knowledge, this is the third case report of this kind.…”

Section: Discussionsupporting

confidence: 70%

Concomitant Fracture Radial Head and Shaft With Dislocation of the Distal Radioulnar Joint: A Rare Variant of the Essex-Lopresti Lesion

Kaul

Sood²,

Akhoon³

2022

JAAOS Glob Res Rev

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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. We describe an atypical Essex-Lopresti variant comprising a radial head and shaft fracture with an associated distal radioulnar joint dislocation in a 36-year-old man.T he classic Essex-Lopresti lesion, which comprises a fracture of the radial head, disruption of the interosseous membrane, and a dislocation of the distal radioulnar joint (DRUJ), was first introduced by Curr and Coe 1 in 1946 and later described and named after Peter Essex-Lopresti 2 in 1951. Another eponymous fracture, named after Italian surgeon, Riccardo Galeazzi, 3,4 comprises a fracture of the radial shaft along with disruption of the DRUJ. The mechanism of injury in both these injuries is similar, primarily, an axially directed force along the long axis of the forearm, which results in a traumatic dislocation of the DRUJ, disruption of the interosseous membrane, and with continued force, a compression type fracture or dislocation of the radial head. A few rare variants of the abovementioned patterns have been described in the literature, although the combination of a Galeazzi fracture and an Essex-Lopresti lesion has been reported only twice. We report a distinct and rare variant of the abovementioned combination which comprised a concomitant radial head and shaft fracture along with a DRUJ dislocation.

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Section: Discussionsupporting

confidence: 70%

Concomitant Fracture Radial Head and Shaft With Dislocation of the Distal Radioulnar Joint: A Rare Variant of the Essex-Lopresti Lesion

Kaul

Sood²,

Akhoon³

2022

JAAOS Glob Res Rev

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“…To the best of the authors' knowledge, PRUJ dislocation with IOM rupture, radius fracture, and DRUJ dislocation (1.2IR.3)-a very rare pattern of forearm joint fracture-dislocation-has only been reported in five cases in literature, by Kedous, Jones, Khurana, Falsafi, and Eglseder [54][55][56][57][58].…”

Section: Three-locker Injuriesmentioning

confidence: 99%

Fracture–dislocations of the forearm joint: a systematic review of the literature and a comprehensive locker-based classification system

et al. 2020

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Background Monteggia, Galeazzi, and Essex-Lopresti injuries are the most common types of fracture–dislocation of the forearm. Uncommon variants and rare traumatic patterns of forearm fracture–dislocations have sometimes been reported in literature. In this study we systematically review the literature to identify and classify all cases of forearm joint injury pattern according to the forearm joint and three-locker concepts. Methods A comprehensive search of the PubMed database was performed based on major pathological conditions involving fracture–dislocation of the forearm. Essex-Lopresti injury, Monteggia and Galeazzi fracture–dislocations, and proximal and/or distal radioulnar joint dislocations were sought. After article retrieval, the types of forearm lesion were classified using the following numerical algorithm: proximal forearm joint 1 [including proximal radioulnar joint (PRUJ) dislocation with or without radial head fractures], middle radioulnar joint 2, if concomitant radial fracture R, if concomitant interosseous membrane rupture I, if concomitant ulnar fracture U, and distal radioulnar joint 3 [including distal radioulnar joint (DRUJ) dislocation with or without distal radial fractures]. Results Eighty hundred eighty-four articles were identified through PubMed, and after bibliographic research, duplication removal, and study screening, 462 articles were selected. According to exclusion criteria, 44 full-text articles describing atypical forearm fracture–dislocation were included. Three historical reviews were added separately to the process. We detected rare patterns of two-locker injuries, sometimes referred to using improper terms of variant or equivalent types of Monteggia and Galeazzi injuries. Furthermore, we identified a group of three-locker injuries, other than Essex-Lopresti, associated with ulnar and/or radial shaft fracture causing longitudinal instability. In addition to fracture–dislocations commonly referred to using historical eponyms (Monteggia, Galeazzi, and Essex-Lopresti), our classification system, to the best of the authors’ knowledge, allowed us to include all types of dislocation and fracture–dislocation of the forearm joint reported in literature. According to this classification, and similarly to that of the elbow, we could distinguish between simple dislocations and complex dislocations (fracture–dislocations) of the forearm joint. Conclusions All injury patterns may be previously identified using an alphanumeric code. This might avoid confusion in forearm fracture–dislocations nomenclature and help surgeons with detection of lesions, guiding surgical treatment. Level of evidence V.

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An uncommon variant of the Essex-Lopresti injury

Cited by 2 publications

References 20 publications

Concomitant Fracture Radial Head and Shaft With Dislocation of the Distal Radioulnar Joint: A Rare Variant of the Essex-Lopresti Lesion

Concomitant Fracture Radial Head and Shaft With Dislocation of the Distal Radioulnar Joint: A Rare Variant of the Essex-Lopresti Lesion

Fracture–dislocations of the forearm joint: a systematic review of the literature and a comprehensive locker-based classification system

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