[Diagnosis and treatment of the Essex-Lopresti lesion. Literature review and four case reports].

BACKGROUND

A fracture of the radial head in combination with a rupture of the interosseous membrane and lesion of the distal radioulnar joint known as Essex-Lopresti lesion is a rare injury. Usually it is caused by a high-energy trauma. Initially unrecognized distal radioulnar dislocations often show poor results.

MATERIAL AND METHOD

Four case reports are presented to discuss the trauma mechanism together with diagnostic and treatment options. Especially the accuracy of ultrasound to diagnose an interosseous membrane disruption was evaluated.

RESULTS

After an average of 35 months all patients were examined using the Morrey score and the modified score of Green and O'Brien. Initially the extent of the injury was not diagnosed in three cases. According to the score values the average results have been fair.

CONCLUSIONS

An early diagnosis is the key for the correct treatment of an Essex-Lopresti lesion based on the classification of Edwards and Jupiter. In addition to the clinical and radiological assessment ultrasound should be used to diminish the rate of unrecognized interosseous membrane disruptions.