Hutchinson Shirley, Faber Kenneth J, Gan Bing Siang
The University of Western Ontario, London, Ontario.
Can J Plast Surg. 2006 Winter;14(4):215-8. doi: 10.1177/229255030601400410.
As the scope of plastic surgical practice expands to include disorders of the carpus and wrist, it has become increasingly important for plastic surgeons to understand pathoanatomy that has not traditionally been considered an integral component of training. The Essex-Lopresti injury consists of a radial head fracture with associated injury to the forearm interosseus membrane and longitudinal instability of the distal radioulnar joint. Early recognition of this disorder usually results in a predictable and satisfactory outcome. However, when this disorder is unrecognized, late reconstruction is challenging and unpredictable, and treatment may be misdirected to the wrist alone if the forearm and elbow are not considered as a component of this injury. The present report describes the importance of examining the elbow in all cases of wrist pain. As well, the literature is reviewed regarding the differences in treatment of acute and chronic Essex-Lopresti injuries. As plastic surgeons become more involved in the treatment of wrist injuries, the conscientious practitioner should be aware of more complicated pathology that may present as a seemingly straightforward wrist problem.
随着整形外科实践的范围扩大到包括腕骨和手腕疾病，整形外科医生了解传统上不被视为培训不可或缺组成部分的病理解剖学变得越来越重要。埃塞克斯-洛普雷斯蒂损伤包括桡骨头骨折以及相关的前臂骨间膜损伤和下尺桡关节的纵向不稳定。早期识别这种疾病通常会带来可预测且令人满意的结果。然而，当这种疾病未被识别时，晚期重建具有挑战性且不可预测，如果不将前臂和肘部视为该损伤的一部分，治疗可能会仅针对手腕而出现偏差。本报告描述了在所有手腕疼痛病例中检查肘部的重要性。此外，还回顾了有关急性和慢性埃塞克斯-洛普雷斯蒂损伤治疗差异的文献。随着整形外科医生越来越多地参与手腕损伤的治疗，认真的从业者应该意识到可能表现为看似简单的手腕问题的更复杂病理情况。
