Xiang Feng, Zhang Ding-Qi, Guo Juan, Li Xing, Zhang Xi-Ping, Li Yan-Jun, Wen Jie
Department of Traumatic Orthopedics, Zhuzhou Central Hospital, The Affiliated Zhuzhou Hospital of Xiangya Medical College, Central South University, Zhuzhou 412007, Hunan Province, China.
Department of Humanities and Journalism, Xiamen University Tan Kah Kee College, Zhangzhou 363123, Fujian Province, China.
World J Orthop. 2025 Jun 18;16(6):106758. doi: 10.5312/wjo.v16.i6.106758.
Essex-Lopresti injury is characterized by a radial head fracture accompanied by dislocation of the distal radioulnar joint and rupture of the interosseous membrane (IOM). This type of injury typically results from high-energy axial forces transmitted through the wrist to the elbow, leading to tears in the IOM, fractures of the radial head, injuries to the distal radioulnar joint, and disruption of the triangular fibrocartilage complex, ultimately causing axial instability of the radioulnar joint. Due to its complexity, this injury is often overlooked in clinical settings, with a reported misdiagnosis rate as high as 60%. In pediatric cases, the misdiagnosis rate is even higher due to children's limited ability to articulate symptoms, the presence of substantial cartilaginous structures that have not fully ossified, and less typical radiographic findings compared to adults. This review aims to provide a comprehensive overview of the injury mechanism, clinical presentation, diagnosis, and treatment of Essex-Lopresti injuries in children, emphasizing the importance for pediatric orthopedists to recognize and manage this condition accurately to prevent misdiagnosis and inappropriate treatment.
埃塞克斯-洛普雷斯蒂损伤的特征是桡骨头骨折，伴有下尺桡关节脱位和骨间膜（IOM）破裂。这种损伤通常由通过腕部传递至肘部的高能轴向力所致，导致骨间膜撕裂、桡骨头骨折、下尺桡关节损伤以及三角纤维软骨复合体破坏，最终引起尺桡关节轴向不稳定。由于其复杂性，这种损伤在临床中常被忽视，据报道误诊率高达60%。在儿科病例中，由于儿童表达症状的能力有限、存在大量尚未完全骨化的软骨结构以及与成人相比不太典型的影像学表现，误诊率甚至更高。本综述旨在全面概述儿童埃塞克斯-洛普雷斯蒂损伤的损伤机制、临床表现、诊断和治疗，强调小儿骨科医生准确识别和处理这种情况以防止误诊和不恰当治疗的重要性。
