Matson Andrew P, Ruch David S
Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina.
J Wrist Surg. 2016 Aug;5(3):172-8. doi: 10.1055/s-0036-1584544. Epub 2016 Jun 20.
Essex-Lopresti injuries (ELIs) are characterized by fracture of the radial head, disruption of the forearm interosseous membrane, and dislocation of the distal radioulnar joint. This injury pattern results in axial and longitudinal instability of the forearm. Initial radiographs may fail to reveal the full extent of the injury, and therefore diagnosis in the acute setting requires a high index of suspicion. Early recognition and treatment are preferred as failure to fully treat the problem may result in chronic wrist pain from ulnar abutment or chronic elbow pain from radiocapitellar arthrosis. In this article the presentation, relevant anatomy, and management options for ELIs are overviewed, and a summary of outcomes reported in the literature is provided. Additionally, the preferred surgical technique of the senior author is presented, which involves reconstruction of the interosseous membrane with a local pronator rerouting autograft.
埃塞克斯-洛普雷斯蒂损伤（ELIs）的特征是桡骨头骨折、前臂骨间膜断裂以及下尺桡关节脱位。这种损伤模式会导致前臂的轴向和纵向不稳定。最初的X线片可能无法显示损伤的全部范围，因此在急性期进行诊断需要高度的怀疑指数。早期识别和治疗是首选，因为未能充分治疗该问题可能会导致尺骨撞击引起的慢性腕部疼痛或桡骨头关节病引起的慢性肘部疼痛。本文概述了ELIs的临床表现、相关解剖结构和治疗选择，并提供了文献报道结果的总结。此外，还介绍了资深作者首选的手术技术，该技术包括用局部旋前肌改道自体移植物重建骨间膜。
