Fracture-dislocation of the elbow with inferior radioulnar dislocation: a variant of the the Essex-Lopresti injury

Bock, Gerhard W.; Cohen, Mark S.; Resnick, Donald

doi:10.1007/bf00241772

Cited by 29 publications

(10 citation statements)

References 6 publications

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“…The Essex-Lopresti lesion is frequently associated with Monteggia-like lesions; in this condition, radio-ulnar pinning and/or TFCC repair may be indicated when DRUJ instability persists after treatment of the radial head [60][61][62]. After ORIF and ligaments reconstruction, the elbow should be evaluated under fluoroscopy to verify the recovery of ulno-humeral, radio-humeral and proximal radio-ulnar joint stability.…”

Section: Monteggia-like-lesionsmentioning

confidence: 99%

Management of complex elbow instability

et al. 2010

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Complex elbow instability is a challenging injury even for expert elbow surgeons. The preoperative radiographs should be carefully evaluated to recognize all lesions that may occur in complex elbow instabilities. Recognizing all the possible lesions is critical to achieve an optimal outcome. The most common types of injuries are as follows: (1) radial head fractures associated with lateral and medial collateral ligaments lesions (with or without elbow dislocation); (2) Coronoid fractures and lateral collateral ligament lesion (with or without elbow dislocation); (3) Terrible Triad; (4) Transolecranon fracture-dislocation; (5) Monteggia-like-lesions; and (6) Humeral Shear fractures associated with lateral and medial collateral ligaments lesions (with or without elbow dislocation). A correct evaluation includes X-rays, CT scan with 2D and 3D reconstruction and stability test under fluoroscopy. The treatment is always surgical and is challenging, and outcomes are not predictable. The goals of treatment are (1) to perform a stable osteosynthesis of all fractures, (2) to obtain concentric and stable reduction of the elbow and (3) to allow early motion. The proximal ulna must be anatomically reduced and fixed; the radial head must be repaired or replaced, and the coronoid fractures must be repaired or reconstructed. With respect of soft tissue lesions, the LUCL must be reattached with suture anchors or trans-osseous suture. The next critical step is the intra-operative assessment of elbow stability. If the elbow remains unstable, MCL repair and/or application of hinged external fixator must be considered. The most recent clinical and experimental studies have significantly expanded our knowledge of elbow instability and its management. Definite treatment protocols may improve the clinical results of such complex injuries.

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Section: Monteggia-like-lesionsmentioning

confidence: 99%

Management of complex elbow instability

et al. 2010

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“…High-resolution MRI and MRI arthrogram are more commonly used to make the diagnosis. 2,3,12,21,25,57 In the experience of my colleagues and I, there is a high false-negative rate with the MRI. We reviewed 20 cases of arthroscopically proven triangular fibrocartilage complex tears and only 8 of the 20 MRIs were positive (Rettig and Marcheschi, unpublished data, 2001).…”

Section: Distal Radioulnar Joint and Triangular Fibrocartilage Complementioning

confidence: 99%

Athletic Injuries of the Wrist and Hand

Rettig

2003

Am J Sports Med

147

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Hand and wrist injuries in sports are some of the most common injuries reported. This review discusses briefly the causes of hand and wrist injuries in sports and discusses pertinent biomechanical findings regarding the range of motion required in different sports activities. The bulk of the review discusses specific traumatic and overuse injuries to the hand and wrist commonly seen in the athlete. Emphasis is placed on problematic traumatic injuries such as carpal scaphoid fractures and hook of the hamate fractures, as well as ligament injuries to the wrist with regard to diagnosis, treatment, and return to athletic competition.

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“…The Essex-Lopresti lesion is frequently associated with Monteggia-like lesions; in this condition, the distal radio-ulnar joint (DRUJ) stability must be also evaluated. If instability of DRUJ persists after treatment of the radial head, DRUJ pinning and/or the repair of triangular fibrocartilage complex (TFCC) may be indicated [ [44] , [45] , [46] ].…”

Section: Introductionmentioning

confidence: 99%

How to approach Monteggia-like lesions in adults: A review

Calderazzi

Galavotti

Nosenzo

et al. 2018

Annals of Medicine and Surgery

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Monteggia-like lesions encompass a wide spectrum of fractures of the forearm and elbow associated with dislocations, subluxations and ligamentous lesions.Many attempts have been made to classify these injuries, not only to understand their pathology but also to develop optimal treatments.Unfortunately, although some of these classifications are complete, they are either complex, not immediately usable, or not exhaustive. An orthopedic surgeon who aims to rapidly treat this kind of injury needs a visual classification, and knowledge of the best surgical approach.Monteggia like lesions do not allow for mistakes during surgery, as even a minor error could be prove detrimental to performing and completing all surgical steps.In this paper, based on our extensive experience in treating these rare lesions, we suggest a practical guide to the best surgical approach for various types of Monteggia like lesions.Some technical tips and pitfalls are also described.

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Fracture-dislocation of the elbow with inferior radioulnar dislocation: a variant of the the Essex-Lopresti injury

Cited by 29 publications

References 6 publications

Management of complex elbow instability

Management of complex elbow instability

Athletic Injuries of the Wrist and Hand

How to approach Monteggia-like lesions in adults: A review

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