Hii J W S, Page M M, Prosser A, Bauer S
Department of Orthopaedics and Trauma Surgery, Royal Perth Hospital, Perth, Western Australia, Australia.
BMJ Case Rep. 2013 Nov 27;2013:bcr2013200295. doi: 10.1136/bcr-2013-200295.
Essex-Lopresti injuries are rare and present a clinical challenge. Incomplete diagnosis and treatment can lead to long-term instability, pain and functional impairment. We report on a clinical case of proximal radioulnar joint (PRUJ) and distal radioulnar joint (DRUJ) dislocation with unusual distal radial displacement and associated radial head shear fracture. The case was managed with closed reduction of the PRUJ and DRUJ followed by open reduction and fixation of the radial head. A high index of suspicion with thorough examination of the elbow, forearm and wrist and comprehensive imaging was important in reaching a complete diagnosis for appropriate treatment. Anatomical reduction of the PRUJ and DRUJ is essential to achieve optimal functional outcomes. Six months following the injury the patient made a satisfactory recovery with full range of movement; however, she continued to have mild to moderate general and moderate work-related disability.
埃塞克斯-洛普雷斯蒂损伤较为罕见，且带来临床挑战。诊断和治疗不完整可导致长期不稳定、疼痛和功能障碍。我们报告一例近端桡尺关节（PRUJ）和远端桡尺关节（DRUJ）脱位并伴有不寻常的桡骨远端移位及相关桡骨头剪切骨折的临床病例。该病例采用PRUJ和DRUJ闭合复位，随后进行桡骨头切开复位内固定治疗。对肘部、前臂和腕部进行全面检查并结合综合影像学检查，保持高度怀疑指数，对于做出完整诊断以进行恰当治疗至关重要。PRUJ和DRUJ的解剖复位对于实现最佳功能预后至关重要。受伤六个月后，患者恢复良好，活动范围正常；然而，她仍有轻度至中度的全身不适以及中度的与工作相关的残疾。
