Results of radial head prostheses implanted during Essex-Lopresti syndrome in multicentric study

2021 ◽  
Author(s):  
Hugo Barret ◽  
Luc Favard ◽  
Pierre Mansat ◽  
Matthias Winter ◽  
Philippe Clavert ◽  
...  
Keyword(s):  
Radial Head ◽  
Multicentric Study ◽  
Essex Lopresti

Radius and Ulna Trauma

2019 ◽  
pp. 65-67
Author(s):  
Michael O’Keeffe ◽  
Kiran Khursid ◽  
Peter L. Munk ◽  
Mihra S. Taljanovic
Keyword(s):  
Radial Head ◽  
Distal Radioulnar Joint ◽  
Monteggia Fracture ◽  
Radial Head Fractures ◽  
Type Iv ◽  
Ulnar Fracture ◽  
Fracture Dislocations ◽  
Diaphyseal Fractures ◽  
Both Bones ◽  
Essex Lopresti

Chapter 15 discusses radius and ulna trauma. Forearm fractures are common and may be isolated to the ulna or more commonly involve both bones. Fractures of the radius or ulna are usually because of direct trauma and are often displaced. Depending on their complexity, isolated fractures of the ulnar diaphysis may be treated nonoperatively or operatively whereas both bone (radius and ulna) diaphyseal fractures are typically treated operatively. Galeazzi fracture-dislocations are comprised of radial diaphyseal fractures in association with distal radioulnar joint (DRUJ) dislocation/subluxation. Monteggia fracture-dislocations are comprised of a proximal ulnar fracture in association with radial head dislocation. In type IV Monteggia injuries, there is an additional fracture of the proximal radial diaphysis. Essex-Lopresti fracture-dislocations include radial head fractures in association with DRUJ dislocation/subluxation.

The Essex-Lopresti Injury: A Variation

1988 ◽  
Vol 13 (4) ◽  
pp. 450-452
Author(s):  
E. J. HARGADON ◽  
M. L. PORTER
Keyword(s):  
Radial Head ◽  
Radial Head Fracture ◽  
Fracture Dislocation ◽  
Essex Lopresti

The Essex-Lopresti fracture-dislocation consists of a radial head fracture associated with dislocation of the inferior radio-ulnar joint. We report a variation of this injury in which there was an additional fracture through the scaphoid.

scholarly journals The Serially-Operated Essex-Lopresti Injury: Long-Term Outcomes in a Retrospective Cohort

2020 ◽  
Vol 12 (01) ◽  
pp. 47-55
Author(s):  
Svenna H. W. L. Verhiel ◽  
Sezai Özkan ◽  
Christopher G. Langhammer ◽  
Neal C. Chen
Keyword(s):  
Upper Extremity ◽  
Radial Head ◽  
Rating Scale ◽  
Case Series ◽  
Outcome Evaluation ◽  
Pain Severity ◽  
Measurement Information ◽  
Radial Head Arthroplasty ◽  
Patient Reported ◽  
Essex Lopresti

Abstract Objective The main aim of this article is to report 10-year outcomes after Essex-Lopresti injury (ELI). Study Design Retrospective case series. Two level I trauma centers and one associated community hospital from 2003 to 2016. Patients Sixteen patients who sustained an ELI and were treated at one of our three regional hospitals. Intervention Initially, 4 patients (25%) were treated nonoperatively by immobilization and 12 patients (75%) were treated operatively. Proximal surgery included radial head open reduction and internal fixation (ORIF), radial head arthroplasty, radial head excision and forearm ORIF, and wound debridement. Ten patients (63%) were acutely identified with longitudinal forearm instability. Of these, four patients had the distal radioulnar joint pinned. In the other six patients, the forearm was immobilized. Overall, 16 patients underwent a total of 32 revision surgeries. Main Outcome Measure Performance of Patient-Reported Outcomes Measurement Information System Upper Extremity (PROMIS UE) Physical score, Numeric Rating Scale (NRS) score for pain-severity, and NRS score for satisfaction of overall outcome. Results Follow-up for outcome evaluation was available for 10 patients, at a median of 10 (interquartile range [IQR]: 8.0–12) years after date of injury. The median PROMIS UE Physical score was 36 (IQR: 33–38). Median NRS score for pain-severity on average was 5 (IQR: 0–6). The median NRS score for satisfaction of overall outcome was 7 (IQR: 5–8). Conclusion Patients who sustain an ELI generally have substantial deficits of upper extremity function as measured by PROMIS UE. Early radial head arthroplasty may be beneficial, but further study in a larger cohort is needed. Outcomes of nonoperative treatment and operative treatment were similar and suggest that current surgical treatments are incomplete.

scholarly journals Long-term Outcome of Surgical Reconstruction of the Interosseous Membrane after Chronic Essex-Lopresti Injury

2020 ◽  
pp. 1-5
Author(s):  
Raul Barco ◽  
Minotta Quebradas MJ ◽  
Antuña SA ◽  
Raul Barco
Keyword(s):  
Radial Head ◽  
Ligament Reconstruction ◽  
Radial Head Fracture ◽  
Interosseous Membrane ◽  
Surgical Reconstruction ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Radial Head Arthroplasty ◽  
Ulnar Shortening Osteotomy ◽  
Essex Lopresti

An Essex-Lopresti injury (ELI) is a rare lesion that describes an interosseous membrane (IOM) disruption associated with dislocation of the distal radio-ulnar joint (DRUJ) and radial head fracture. They are rare and have a tendency to be underdiagnosed in the ER, so it is not uncommon to see chronic cases. As part of the treatment options different IOM reconstructions have been proposed along with associated procedures to the radial head and DRUJ. One of the most effective treatment strategies has been the use of a bone-tendonbone (BTB) patellar graft for IOM reconstruction with promising outcomes. We present a case of 46-yearold man who suffered an Essex-Lopresti injury with a radial head fracture and associated posterolateral elbow instability that was managed initially non-operatively. After failure for continued pain and instability if the elbow and forearm, we treated the patient with a radial head arthroplasty, ligament reconstruction of the posterolateral complex, and DRUJ ligament reconstruction with extensor hallucis tendon without a formal IOM. This operation was successful initially, but continued forearm instability contributed to failure of the RHA and DRUJ reconstruction. A second operation was performed resecting the loosened radial head arthroplasty, performing an ulnar shortening osteotomy, and an IOM reconstruction with BTB allograft. After eight years of follow-up the patient is very satisfied with the procedure and rates his elbow as almost normal. ELI are rare and represent a severe injury of the forearm with axial and transverse instability, leading to severe symptoms and instability of the forearm. Initial diagnosis is challenging, and acute treatment yields better results than chronic cases. IOM reconstruction seems to be necessary in the setting of chronic reconstructions, along with other procedures to balance the forearm. We review different IOM grafting options and associated procedures for the treatment of these challenging injuries.

Radial Head Arthroplasty for Acute and Chronic Essex-Lopresti Lesions

2020 ◽  
Vol 29 (4) ◽  
pp. e148-e149
Author(s):  
William R. Aibinder ◽  
Laura A. Sims ◽  
Graham J. King ◽  
Kenneth J. Faber
Keyword(s):  
Radial Head ◽  
Radial Head Arthroplasty ◽  
Essex Lopresti

Reconstruction of the forearm interosseous membrane: a biomechanical study of three different techniques

2019 ◽  
Vol 45 (4) ◽  
pp. 360-368
Author(s):  
Panagiotis T. Masouros ◽  
Emmanuel P. Apergis ◽  
Andreas F. Mavrogenis ◽  
George C. Babis ◽  
Dendi K. Artemi ◽  
...  
Keyword(s):  
Mechanical Testing ◽  
Radial Head ◽  
Biomechanical Study ◽  
Interosseous Membrane ◽  
Longitudinal Stability ◽  
Normal Loading ◽  
Loading Pattern ◽  
Flexor Carpi Radialis ◽  
Pronator Teres ◽  
Essex Lopresti

Reconstruction of the interosseous membrane has the potential to re-establish a normal loading pattern through the forearm and enhance stability after an Essex-Lopresti lesion. The aim of our study was to assess the capacity of three different techniques, which all use a regionally harvested autograft, to restore longitudinal stability. Simulation of the Essex-Lopresti lesion was done by excising the radial head and sectioning the interosseous membrane in seven cadaveric specimens. Each technique was used in each specimen consecutively, using the pronator teres, the brachioradialis and the flexor carpi radialis tendons, respectively. The specimens were submitted to mechanical testing by applying proximally migratory forces to the radius and radioulnar displacement was assessed fluroscopically at wrist level. The pronator teres tendon achieved the greatest reduction (94% correction with respect to the intact interosseous membrane/radial head out state, followed by brachioradialis (92%) and flexor carpi radialis (85%). However, no statistically significant differences in displacement data or strength were detected between the techniques.

The Essex–Lopresti Lesion: A Variant with a Bony Distal Radioulnar Joint Injury

2006 ◽  
Vol 31 (2) ◽  
pp. 206-207 ◽  
Author(s):  
J. AUYEUNG ◽  
G. BROOME
Keyword(s):  
Radial Head ◽  
Radial Head Fracture ◽  
Soft Tissue Injuries ◽  
Distal Radioulnar Joint ◽  
Joint Injury ◽  
Radioulnar Joint ◽  
Membrane Rupture ◽  
Ulnar Head ◽  
Proximal Migration ◽  
Essex Lopresti

The Essex–Lopresti lesion is an unusual injury, consisting of a radial head or neck fracture, distal radioulnar joint (DRUJ) injury and interosseous membrane rupture. To date, all reported Essex–Lopresti lesions have consisted of soft tissue injuries at the DRUJ. We present a case of an Essex–Lopresti lesion with a bony variant, in which the DRUJ injury consisted of an ulnar head fracture associated with radial head fracture and acute proximal migration of the radius. The management involved plating of the ulnar head fracture and titanium replacement of the radial head.

FAILURE OF FRESH-FROZEN RADIAL HEAD ALLOGRAFTS IN THE TREATMENT OF ESSEX-LOPRESTI INJURY

2005 ◽  
Vol 87 (8) ◽  
pp. 1828-1833 ◽  
Author(s):  
RYAN KARLSTAD ◽  
BERNARD F. MORREY ◽  
WILLIAM P. COONEY
Keyword(s):  
Radial Head ◽  
Fresh Frozen ◽  
Essex Lopresti
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