Stefano Artiaco1, Federico Fusini2, Giulia Colzani3, Alessandro Massè1, Bruno Battiston1. 1. Department of Orthopaedics and Traumatology, Orthopaedic and Trauma Center, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Via Zuretti, 10126, Torino, Italy. 2. Department of Orthopaedics and Traumatology, Orthopaedic and Trauma Center, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Via Zuretti, 10126, Torino, Italy. fusinif@hotmail.com. 3. Department of Orthopaedics and Traumatology, Policlinico di Modena, Azienda Ospedaliera Universitaria, Modena, Italy.
Abstract
INTRODUCTION: Essex-Lopresti lesion (ELL) is a severe injury. Most of ELL is recognized in chronic phase representing a therapeutic challenge for orthopaedic surgeons. The aim of this systematic review is to highlight and criticize current concepts in the surgical treatment. MATERIALS AND METHODS: The search was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guideline. A comprehensive research of Pubmed database was made using the following Mesh term: ((Essex-Lopresti injury) OR (Essex Lopresti) OR (distal radio ulnar dissociation) OR (distal radio ulnar dislocation) OR (longitudinal forearm instability)). Quality assessment of each article was performed according to Coleman score by two authors. RESULTS: Eight full articles were included to the systematic review. Surgical treatment was differentiated in five categories according to the most common procedure reported in clinical series. The mean Coleman Score was 51.13 ± 9.76. DISCUSSION: Case series reported in the literature include a limited number of patients with chronic ELL. Currently, salvage procedure devoted to treat a wrong diagnosis and an incorrect treatment is used. Radial head replacement together with ulnar shortening osteotomy and interosseous membrane reconstruction are the most common treatments of choice, but at present, there is not yet a shared scheme of management for patients with chronic ELL. CONCLUSIONS: According to current literature, a case-by-case treatment must always be considered. Further investigations, with higher level of evidence, quality of study design, and number of patients, are needed to better assess clinical results and complication of each technique. LEVEL OF EVIDENCE: IV.
INTRODUCTION: Essex-Lopresti lesion (ELL) is a severe injury. Most of ELL is recognized in chronic phase representing a therapeutic challenge for orthopaedic surgeons. The aim of this systematic review is to highlight and criticize current concepts in the surgical treatment. MATERIALS AND METHODS: The search was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guideline. A comprehensive research of Pubmed database was made using the following Mesh term: ((Essex-Lopresti injury) OR (Essex Lopresti) OR (distal radio ulnar dissociation) OR (distal radio ulnar dislocation) OR (longitudinal forearm instability)). Quality assessment of each article was performed according to Coleman score by two authors. RESULTS: Eight full articles were included to the systematic review. Surgical treatment was differentiated in five categories according to the most common procedure reported in clinical series. The mean Coleman Score was 51.13 ± 9.76. DISCUSSION: Case series reported in the literature include a limited number of patients with chronic ELL. Currently, salvage procedure devoted to treat a wrong diagnosis and an incorrect treatment is used. Radial head replacement together with ulnar shortening osteotomy and interosseous membrane reconstruction are the most common treatments of choice, but at present, there is not yet a shared scheme of management for patients with chronic ELL. CONCLUSIONS: According to current literature, a case-by-case treatment must always be considered. Further investigations, with higher level of evidence, quality of study design, and number of patients, are needed to better assess clinical results and complication of each technique. LEVEL OF EVIDENCE: IV.
Authors: Alessandro Liberati; Douglas G Altman; Jennifer Tetzlaff; Cynthia Mulrow; Peter C Gøtzsche; John P A Ioannidis; Mike Clarke; P J Devereaux; Jos Kleijnen; David Moher Journal: J Clin Epidemiol Date: 2009-07-23 Impact factor: 6.437
Authors: Aaron I Venouziou; Loukia K Papatheodorou; Robert W Weiser; Dean G Sotereanos Journal: J Shoulder Elbow Surg Date: 2014-04-22 Impact factor: 3.019
Authors: Michael P Gaspar; Patrick M Kane; Emily M Pflug; Sidney M Jacoby; A Lee Osterman; Randall W Culp Journal: J Shoulder Elbow Surg Date: 2016-06-30 Impact factor: 3.019