The Essex-Lopresti lesion

JOURNAL TITLE: Strategies in Trauma and Limb Reconstruction

Author
1. K. J. Burkhart
2. K. Wegmann
3. L. P. Müller
4. G. P. Brüggemann
5. J. Dargel
ISSN
1828-8936
DOI
10.1007/s11751-012-0149-0
Volume
7
Issue
3
Publishing Year
2012
Pages
9
Author Affiliations
    1. Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitsklinikum Köln, Kerpener Straße 62, 50937 Cologne, Germany
    1. Department for Trauma and Orthopaedic Surgery, Hand and Reconstructive Surgery St. Vinzenz Hospital Merheimer Strasse 221-223 D-50733 Cologne, Germany
    1. Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitsklinikum Köln, Kerpener Straße 62, 50937 Cologne, Germany
    1. Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany
    1. Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitsklinikum Köln, Kerpener Straße 62, 50937 Cologne, Germany
  • Article keywords
    Essex-Lopresti lesion, Longitudinal forearm instability, Radial head fracture, Distal radio-ulnar joint, Interosseous membrane, Radial head prosthesis

    Abstract

    The Essex-Lopresti lesion represents a severe injury of the forearm unit. In the 1940s, it's pathology and consequences have already been mentioned by several authors. Over the course of time, the pathophysiology of the lesion was displayed in more detail. Therefore, an intensive analysis of the involved anatomic structures was done. The interosseous membrane was shown to play a major role in stabilising the forearm unit, in the situation of a fractured radial head, which is the primary stabiliser of the longitudinal forearm stability. Moreover, biomechanical analyses showed a relevant attribution of the distal radio-ulnar joint to the forearm stability. If, in the case of a full-blown Essex-Lopresti lesion, the radial head, the interosseous membrane and the distal radio-ulnar joint are injured, proximalisation of the radius will take place and will come along with secondary symptoms at the elbow joint and the wrist. According to actual studies, the lesion seems to occur more often than realised up to now. Thus, to avoid missing the complex injury, subtle clinical diagnosis combined with adequate imaging has to be undertaken. If the lesion is confirmed, several operative treatment options are available, yet not proofed to be sufficient.

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