Essex-Lopresti fracture

The Essex-Lopresti fracture is a fracture of the radial head with concomitant dislocation of the distal radio-ulnar joint and disruption of the interosseous membrane.[1] The injury is named after Peter Essex-Lopresti who described it in 1951.[2]

Essex-Lopresti fracture
SpecialtyOrthopaedics
SymptomsDislocation of the forearm
ComplicationsMal-Union
TreatmentOpen reduction and internal fixation with plates
PrognosisGood if treated early
DeathsRare

Descriptive image link

Cause

This fracture occurs in patients who have fallen from a height.

Diagnosis

The injury can be difficult to diagnose initially as the attention is focused on the injury to the radial head, leading to the distal radio-ulnar injury being overlooked. The examination finding of tenderness of the distal radio-ulnar joint suggests an Essex-Lopresti injury in patients who have sustained high energy forearm trauma. Plain radiography shows the radial head fracture, with dorsal subluxation of the ulna often seen on lateral view of the pronated wrist.[1]

Management

The radial head fracture is usually managed by open reduction internal fixation; if the fracture is too comminuted, a radial head implant can be used. Excision of the radial head should be avoided, as the radius will migrate proximally leading to wrist pain and loss of pronation and supination of the wrist. Delayed treatment of the radial head fracture will also lead to proximal migration of the radius.[3]

The distal radio-ulnar joint dislocation can be reduced by supination of the forearm, and may be pinned in place for 6 weeks to allow healing of the interosseous membrane.[1]

gollark: Run the Linux source code through TTS and play it as you sleep.
gollark: Contribute to my projects! I have tons of unfinished ones!
gollark: They're quite rare and are patched rapidly; you can be reasonably confident webpages will not hackerize your computer. It's much more secure than "ahh yes I will write this program directly to the boot sector".
gollark: Browsers are FAIRLY safe.
gollark: Hence browsers and stuff.

References
  1. Essex Lopresti fracture at Wheeless' Textbook of Orthopaedics online
  2. Essex-Lopresti, P (May 1951). "Fractures of the radial head with distal radio-ulnar dislocation: report of two cases". J Bone Joint Surg Br. 33B (2): 244–7. PMID 14832324.
  3. Edwards, GS Jr.; Jupiter JB (Sep 1988). "Radial head fractures with acute radioulnar dislocation. Essex-Lopresti revisited". Clin Orthop Relat Res (234): 61–9. PMID 3409602.
Classification
External resources
This article is issued from Wikipedia. The text is licensed under Creative Commons - Attribution - Sharealike. Additional terms may apply for the media files.