Extract
Essex-Lopresti described a traumatic radial head fracture with
associated disruption of the interosseous membrane and secondary proximal
migration of the
radius1. The
combined long-term effect of this injury on the radiocapitellar and distal
radioulnar joints is both pain and loss of
mobility2-5.Reconstructive management of these lesions has been very difficult and has
yielded variable, mostly unfavorable
results2,6.
The accepted basis of management consists of reestablishing the longitudinal
relationship of the radius to the ulna. This allows anatomic realignment of
the proximal radioulnar joint, the distal radioulnar joint, the proximal and
distal ligaments, and the interosseous membrane. This can be accomplished by
reestablishing the length of the proximally migrated radius, by shortening the
ulna, or by a combination of the two.