Essex-Lopresti injuries: an update

Abstract

Reconstruction of the central band of the interosseous membrane is an emerging procedure implemented in the treatment of longitudinal radioulnar dissociation (LRUD), usually in its chronic setting, after Essex-Lopresti injuries of the forearm. There are no sufficient clinical data to support reconstruction of the central band of the interosseous membrane in acute LRUD injuries. Clinical and cadaveric studies comparing autografts (palmaris longus, flexor carpi radialis and bone-patellar-bone), allografts (Achilles tendon) and synthetic ligaments have not shown superiority of one technique versus another; however, they have shown special concerns with respect to the use of synthetic grafts. Latrogenic fracture, decrease of rotational range of movement, iatrogenic nerve injury (superficial radial and median nerve), donor site morbidity with autografts and recurrent instability are the complications reported in literature after interosseous membrane reconstruction. Cite this article: EFORT Open Rev 2019;4:143-150. DOI: 10.1302/2058-5241.4.180072

Radiographic Evaluation of Elbow Fractures

“…This pattern of injury is composed of a comminuted fracture of the radial head, coupled with proximal migration of the radius, that results in dislocation of the radioulnar joint and rupture of the interosseous membrane between the radius and the ulna. 17 Rates of missed diagnosis were reported as high as 60% due in part to a focus on the radial head injury and satisfaction of search, 17 and complaints of concomitant wrist tenderness or pain should prompt careful scrutiny of the distal radioulnar joint. A difference in the distal radioulnar interval > 5 mm relative to the contralateral uninjured wrist suggests the diagnosis, 13 although a lower threshold of only 2 mm of radial shortening in two planes may be warranted.…”

To Reconstruct or Not: A Case of Acute Reconstruction of the Forearm Interosseous Membrane with CMC Mini Tight Rope

“…The usual mechanism for such an injury is axial compression to the forearm while the elbow is extended [ 2 , 3 ]. Extent of injury to the IOM is variable and thus contributes to a reported 60% of missed diagnoses at initial presentation [ 4 , 5 ].…”

“…While there is a consensus for IOM reconstruction in chronic cases of longitudinal radioulnar instability [ 3 , 6 , 7 , 8 ], there is minimal information regarding support for acute IOM reconstruction and surgical technique for such cases [ 5 ]. Prior literature in this area has focused on cadaveric, biomechanic, or chronic reconstruction studies [ 9 , 10 , 11 , 12 ].…”

Floating forearm associated with terrible triad injury and Essex-Lopresti injury: a case report and literature review

“…ELI consists of a characteristic triad: a comminuted radial head fracture, disruption of the distal radioulnar joint (DRUJ), and tearing of the interosseous membrane (IOM). 15 Similar to TTI, ELI occurs when a high-energy load is axially applied to the forearm, usually as a result of a fall on an outstretched hand. 15 …”

“… 15 Similar to TTI, ELI occurs when a high-energy load is axially applied to the forearm, usually as a result of a fall on an outstretched hand. 15 …”