Characteristics and treatments of the Essex-Lopresti injury

Abstract

To summarize experiences of operative treatment for Essex-Lopresti injury, and analyze the effect of the compare repair of interosseous membrane of forearm(IOM)on the forearm function. Twenty-four patients of Essex-Lopresti injury were treated from January 2005 to December 2013, 16 patients(group A) with radius and/or ulna fractures were treated with open reduction and internal fixation of radius or ulna and repair of forearm bone membrane at the same time, and then treated with open reduction and internal fixation of head of radius, as well as lower ulnar joint fixation or repair of wrist triangle fiber complex. Another 8 patients without radius and or ulna fractures(group B) were treated with open reduction and internal fixation of head of radius, as well as lower ulnar joint fixation or repair of wrist triangle fiber complex. The wrist joint function was evaluated using Cooney wrist functional rating index, and the elbow joint function was evaluated using Mayo elbow-performance score 2 weeks and 2 years after operation. According to Cooney wrist functional rating index, 4 patients in group A got a fair result and 12 poor, 2 patients in group B got a fair result and 6 poor 2 weeks after operation; 8 patients in group A got a good result, 6 fair and 2 poor, 5 patients in group B got a good result, 2 fair and 1 poor 2 years after operation. According to Mayo elbow-performance score, 2 patients in group A got a good result, fair and 6 poor, 1 patient in group B got a good result, 5 fair and 2 poor 2 weeks after operation; 8 patients in group A got a good result, 6 fair and 2 poor, 4 patients in group B got a good result, 3 fair and 1 poor. There were no statistically differences between two groups 2 weeks and 2 years after operation. It is important to restore the length of radius and/or ulna and maintain the dynamic stabilization of elbow and wrist for treat Essex-Lopresti injury. The repair of IOM has no effect on the forearm function.