Jnl Wrist Surg 2016; 05(03): 172-178
DOI: 10.1055/s-0036-1584544
Special Focus Section: Interosseous Membrane and Its Effect on DRUJ
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Management of the Essex-Lopresti Injury

Andrew P. Matson
1  Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina
,
David S. Ruch
1  Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina
› Author Affiliations
Further Information

Publication History

17 May 2016

18 May 2016

Publication Date:
20 June 2016 (eFirst)

Abstract

Essex-Lopresti injuries (ELIs) are characterized by fracture of the radial head, disruption of the forearm interosseous membrane, and dislocation of the distal radioulnar joint. This injury pattern results in axial and longitudinal instability of the forearm. Initial radiographs may fail to reveal the full extent of the injury, and therefore diagnosis in the acute setting requires a high index of suspicion. Early recognition and treatment are preferred as failure to fully treat the problem may result in chronic wrist pain from ulnar abutment or chronic elbow pain from radiocapitellar arthrosis. In this article the presentation, relevant anatomy, and management options for ELIs are overviewed, and a summary of outcomes reported in the literature is provided. Additionally, the preferred surgical technique of the senior author is presented, which involves reconstruction of the interosseous membrane with a local pronator rerouting autograft.