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一种罕见的埃塞克斯-洛普雷斯蒂损伤变体。

An uncommon variant of the Essex-Lopresti injury.

作者信息

Kedous Mohamed Ali, Msakni Ahmed, Chebbi Wael, Zaraa Mourad, Mbarek Mondher

机构信息

Trauma Center, Ben Arous, Tunisia.

Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.

出版信息

Skeletal Radiol. 2018 Mar;47(3):397-400. doi: 10.1007/s00256-017-2782-7. Epub 2017 Oct 2.

Abstract

The Essex-Lopresti injury is an extremely rare condition combining radial head or neck fracture, distal radio-ulnar joint dislocation and rupture of the interosseous membrane. However, there are rare or unusual varieties or associated injuries. We report a case of a 46-year-old woman with a posterior dislocation of the radio-humeral joint, a radial shaft fracture, and a distal radio-ulnar joint dislocation. She underwent open reduction and internal fixation of the radial shaft fracture followed by an immobilization by a long elbow splint in supination for 6 weeks. At 18 months of follow-up, she was asymptomatic and she had a full range of elbow and wrist motion and had resumed thoroughly her previous job. The Essex-Lopresti injury results from a complex injury to the forearm axis with resultant longitudinal instability, which can be challenging to treat. There are some variations that can lead to a missed diagnosis resulting in persistent pain and instability of the wrist. The best outcomes are reached with early diagnosis and prompt management.

摘要

埃塞克斯-洛普雷斯蒂损伤是一种极为罕见的病症,它合并了桡骨头或桡骨颈骨折、桡尺远侧关节脱位以及骨间膜破裂。然而,还存在罕见或不寻常的类型或相关损伤。我们报告一例46岁女性病例,其患有肱桡关节后脱位、桡骨干骨折以及桡尺远侧关节脱位。她接受了桡骨干骨折切开复位内固定术,随后使用长肘夹板在旋后位固定6周。随访18个月时,她没有症状,肘部和腕部活动范围正常,并且已完全恢复之前的工作。埃塞克斯-洛普雷斯蒂损伤是由前臂轴线的复杂损伤导致纵向不稳定引起的,治疗起来可能具有挑战性。存在一些变异情况可能导致漏诊,进而引起腕部持续疼痛和不稳定。早期诊断和及时处理能取得最佳治疗效果。

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