Department of Surgery, Princess Alexandra Hospital, Woolloongabba, QLD, Australia.
Australian Research Collaboration on Hands (ARCH), Mudgeeraba, QLD, Australia.
J Hand Surg Asian Pac Vol. 2022 Jun;27(3):574-579. doi: 10.1142/S2424835522720262.
The Essex-Lopresti pattern of injury comprises radial head fracture, distal radioulnar joint (DRUJ) dislocation and disruption of the interosseus membrane (IOM). Diagnosis is often delayed, and reconstruction remains a management dilemma, with several proposed techniques addressing the radial head via either replacement or fixation; reconstruction of the DRUJ ligaments via anatomic or non-anatomic methods; and IOM reconstruction with synthetic grafts, allograft or autograft. We present a 26-year-old man with a chronic Essex-Lopresti injury who underwent revision ulnar shortening osteotomy (USO), IOM reconstruction using a brachioradialis graft and an Adams-Berger ligament reconstruction of the DRUJ ligaments following a three-year course of increasing pain and instability following radial head dislocation. This case demonstrates the feasibility of a single-stage reconstruction of a chronic Essex-Lopresti injury using a brachioradialis and a palmaris longus autograft. Level V (Therapeutic).
埃斯克斯-洛普雷斯特i 型损伤包括桡骨头骨折、下尺桡关节（DRUJ）脱位和骨间膜（IOM）破裂。诊断常常被延误，重建仍然是一个管理难题，有几种提出的技术通过替代或固定来解决桡骨头问题；通过解剖或非解剖方法重建 DRUJ 韧带；以及使用合成移植物、同种异体移植物或自体移植物进行 IOM 重建。我们介绍了一位 26 岁男性，他患有慢性埃斯克斯-洛普雷斯特 i 型损伤，在经历了三年的桡骨头脱位后，疼痛和不稳定逐渐加重，随后接受了桡骨缩短截骨术（USO）修正、肱桡肌移植物重建 IOM 以及亚当斯-伯格韧带重建 DRUJ 韧带。该病例证明了使用肱桡肌和掌长肌腱自体移植物进行慢性埃斯克斯-洛普雷斯特 i 型损伤的一期重建的可行性。 5 级（治疗）。
