A Doser1, M Markmiller, P C Strohm, N P Südkamp. 1. Department für Orthopädie und Traumatologie, Klinikum der Albert-Ludwigs-Universität, Hugstetterstrasse 55, 79106 Freiburg i.B.
Abstract
BACKGROUND: A fracture of the radial head in combination with a rupture of the interosseous membrane and lesion of the distal radioulnar joint known as Essex-Lopresti lesion is a rare injury. Usually it is caused by a high-energy trauma. Initially unrecognized distal radioulnar dislocations often show poor results. MATERIAL AND METHOD: Four case reports are presented to discuss the trauma mechanism together with diagnostic and treatment options. Especially the accuracy of ultrasound to diagnose an interosseous membrane disruption was evaluated. RESULTS: After an average of 35 months all patients were examined using the Morrey score and the modified score of Green and O'Brien. Initially the extent of the injury was not diagnosed in three cases. According to the score values the average results have been fair. CONCLUSIONS: An early diagnosis is the key for the correct treatment of an Essex-Lopresti lesion based on the classification of Edwards and Jupiter. In addition to the clinical and radiological assessment ultrasound should be used to diminish the rate of unrecognized interosseous membrane disruptions.
BACKGROUND: A fracture of the radial head in combination with a rupture of the interosseous membrane and lesion of the distal radioulnar joint known as Essex-Lopresti lesion is a rare injury. Usually it is caused by a high-energy trauma. Initially unrecognized distal radioulnar dislocations often show poor results. MATERIAL AND METHOD: Four case reports are presented to discuss the trauma mechanism together with diagnostic and treatment options. Especially the accuracy of ultrasound to diagnose an interosseous membrane disruption was evaluated. RESULTS: After an average of 35 months all patients were examined using the Morrey score and the modified score of Green and O'Brien. Initially the extent of the injury was not diagnosed in three cases. According to the score values the average results have been fair. CONCLUSIONS: An early diagnosis is the key for the correct treatment of an Essex-Lopresti lesion based on the classification of Edwards and Jupiter. In addition to the clinical and radiological assessment ultrasound should be used to diminish the rate of unrecognized interosseous membrane disruptions.
Authors: Eric W Fester; Peter M Murray; Timothy G Sanders; John V Ingari; John Leyendecker; Henry L Leis Journal: J Hand Surg Am Date: 2002-05 Impact factor: 2.230