Oppermann J, Burkhart K J, Löw S, Müller L P
Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universität zu Köln, Kerpener Straße 62, 50937, Köln, Deutschland.
Cologne Center for Musculoskeletal Biomechanics, Medical Faculty, University of Cologne, Köln, Deutschland.
Orthopade. 2018 Aug;47(8):663-669. doi: 10.1007/s00132-018-3590-z.
The movement of the forearm follows a complex interplay of three main components: the proximal and distal radioulnar joint and the interosseous membrane. Injuries to one or even all components have a huge impact on the integrity of this system. The Essex-Lopresti lesion presented a high challenge in clinical diagnostics as well as therapy. Reconstructions of the length and stability are essential for a satisfactory postoperative outcome. If a reconstruction of the radial head by osteosynthesis is not possible, a radial head prosthesis should be implanted in the case of longitudinal instability - avoiding overlapping and/or oversizing. The reconstruction of the interosseous membrane should be considered, as well as the assessment of the distal radioulnar joint and/or the triangular fibrocartilage complex. Various reconstruction options are available in this regard.
近端和远端桡尺关节以及骨间膜。一个甚至所有组成部分的损伤都会对该系统的完整性产生巨大影响。埃塞克斯-洛普雷斯蒂损伤在临床诊断和治疗方面都面临着巨大挑战。长度和稳定性的重建对于令人满意的术后结果至关重要。如果无法通过骨合成重建桡骨头,在存在纵向不稳定的情况下应植入桡骨头假体——避免重叠和/或尺寸过大。应考虑重建骨间膜,以及评估远端桡尺关节和/或三角纤维软骨复合体。在这方面有各种重建选择。