Uros Meglic1,2, Noemi Szakacs3,4, Margherita Menozzi5, Raul Barco3,6, Eduard Alentorn-Geli3,7,8,9, Alessandra Colozza3,10. 1. Department of Orthopaedic Surgery, University Medical Centre Ljubljana, Zaloska cesta 9, 1000, Ljubljana, Slovenia. u_meglic@yahoo.com. 2. ESSKA Elbow and Forearm Scientific Committee 2020 - 2022, Milan, Italy. u_meglic@yahoo.com. 3. ESSKA Elbow and Forearm Scientific Committee 2020 - 2022, Milan, Italy. 4. Department of Orthopedics, Semmelweis University, Üllői út 78, Budapest, Hungary. 5. Orthopaedic Clinic, Department of Medicine and Surgery, University Hospital of Parma, Viale Antonio Gramsci 14, Parma, Italy. 6. Upper Limb Unit, Department of Orthopaedic Surgery, La Paz University Hospital, Paseo de la Castellana 261, Madrid, Spain. 7. Instituto Cugat, Hospital Quirónsalud Barcelona, Barcelona, Spain. 8. Fundación García-Cugat, Barcelona, Spain. 9. Mutualidad Española de Futbolistas - Delegación Cataluña, Barcelona, Spain. 10. Ortopedia E Traumatologia Ospedale Degli Infermi Faenza, Viale Stradone 9, Faenza, RA, Italy.
Abstract
PURPOSE: In the last two decades, a strong interest on the interosseous membrane (IOM) has developed. METHODS: The authors present a review of the new concepts regarding the understanding of forearm physiology and pathology, with current trends in the surgical management of these rare and debilitating injuries. RESULTS: Anatomical and biomechanical studies have clarified the anatomy of forearm constrains and their role in forearm longitudinal and transverse stability. The radial pull test, a new intraoperative test, has been developed that might increase the detection on IOM injuries. The forearm is now considered a "functional unit" and, consequently, a new classification has been proposed. Uncommon variants and rare patterns of forearm fracture dislocations have been reported in the literature and could not be classified to those commonly referred to using eponyms (Monteggia, Galeazzi, Essex-Lopresti). The new Artiaco et al. classification includes all injury patterns, thus avoids confusion in the nomenclature, and helps surgeon with detection of lesions and guiding surgical treatment. CONCLUSION: Based on the new classification and after current literature review, authors propose a management flowchart for treatment of forearm instability injuries.
PURPOSE: In the last two decades, a strong interest on the interosseous membrane (IOM) has developed. METHODS: The authors present a review of the new concepts regarding the understanding of forearm physiology and pathology, with current trends in the surgical management of these rare and debilitating injuries. RESULTS: Anatomical and biomechanical studies have clarified the anatomy of forearm constrains and their role in forearm longitudinal and transverse stability. The radial pull test, a new intraoperative test, has been developed that might increase the detection on IOM injuries. The forearm is now considered a "functional unit" and, consequently, a new classification has been proposed. Uncommon variants and rare patterns of forearm fracture dislocations have been reported in the literature and could not be classified to those commonly referred to using eponyms (Monteggia, Galeazzi, Essex-Lopresti). The new Artiaco et al. classification includes all injury patterns, thus avoids confusion in the nomenclature, and helps surgeon with detection of lesions and guiding surgical treatment. CONCLUSION: Based on the new classification and after current literature review, authors propose a management flowchart for treatment of forearm instability injuries.
Authors: Emmanuel P Apergis; Panagiotis T Masouros; Vasileios S Nikolaou; George Arealis; George C Babis Journal: Acta Orthop Belg Date: 2019-03 Impact factor: 0.500
Authors: Yaron S Brin; Ezequiel Palmanovich; Asaf Bivas; Paul Sagiv; Evgeny Kotz; Meir Nyska; Benyamin J Kish Journal: Tech Hand Up Extrem Surg Date: 2014-03