Essex-Lopresti fracture

Essex-Lopresti Fracture

The Essex-Lopresti fracture is a severe injury that involves a combination of fractures and dislocations within the forearm and wrist, specifically affecting the radial head, interosseous membrane, and distal radioulnar joint. This injury is named after Peter Essex-Lopresti, who first described it in 1951. The Essex-Lopresti fracture is considered a complex injury due to the involvement of multiple structures and the significant impact it has on the function of the forearm and hand.

Etiology

The Essex-Lopresti fracture typically occurs as a result of a high-energy impact or fall, often with the force transmitted along the length of the radius. This can happen in various scenarios, including vehicular accidents, sports injuries, or falls from a height. The mechanism of injury involves axial compression, pronation, and dorsiflexion of the wrist, leading to the disruption of the radial head, interosseous membrane, and distal radioulnar joint.

Clinical Presentation

Patients with an Essex-Lopresti fracture often present with pain, swelling, and decreased range of motion in the forearm and wrist. There may also be visible deformity, and the patient will typically have difficulty performing pronation and supination of the forearm. Diagnosis is confirmed through physical examination and imaging studies, including X-rays and MRI, which can help to identify the extent of the injury and any associated fractures or dislocations.

Treatment

Treatment of an Essex-Lopresti fracture is complex and typically requires surgical intervention to restore the anatomy and function of the forearm. This may involve open reduction and internal fixation (ORIF) of the radial head fracture, repair or reconstruction of the interosseous membrane, and stabilization of the distal radioulnar joint. Postoperative rehabilitation is crucial to regain range of motion and strength.

Prognosis

The prognosis for patients with an Essex-Lopresti fracture depends on the severity of the injury, the timeliness and effectiveness of treatment, and the patient's adherence to rehabilitation. Complications can include chronic pain, stiffness, and reduced function of the forearm and wrist, as well as the potential for post-traumatic arthritis.

See Also

• Fracture
• Radial head fracture
• Interosseous membrane of the forearm
• Distal radioulnar joint