Diagnosis And Treatment Of Essex-Lopresti Lesion And Literature Review

Objective：Essex-Lopresti lesion is clinically rare,if it not diagnosed andaddressed early,it can result in long term wrist joint problems such as:wrist jointunstability and pain、decrease in grasping power、loss of supination pronation andeffects、the quality of life seriously.The clinical features,diagnosis and treatment are themain contents of this articale.Methods:This research article enrolled3cases suffered from Essex-Loprestilesion。1male and2females.aged from30~56years old (Average:43years)。FromNovember2002to November2011,one with left side and two right side lesions.twowith fresh closed fractures,.mechanism of injury：One is Road traffic accident,One isFall down mechanism。Radial head fracture according to Mason classification：type II-one patient,type III-one patient。The third patient had radial head excision in anotherhospital,because of wrist pain,unstability of distal radio-ulnar joint and limitation ofsupination and pronation。10months later,he came to our hospital.After admission toour hospital,plain X-ray showed dislocation of distal radio-ulnar joint,the sublucation is2-5mm,with upward displacement of distal radius。we used ORIF for radial headfracture with miniplate and screws，for the fresh and2patients and The third patientwas treated with radial head arthroplasty.All of the distal radio-ulnar joint was reducedand fixed。Results: All of the three patients surgical wounds healed by first intension healingand follwed up for10-18months(Average:15months)。plainX-ray showed fracturehealing post operatively14-18weeks(Average:16weeks)。.Neither nonunion, delayunion or malunion nor distal radio-ulnar joint unstability was observed，elbow jointRom by Morrey-Broberg functional criteria showed：1is excellent result;1is goodresult and1with fair result。According to modified distal radio-ulnar joint clinical functional Rom score systerm：1is excellent result and1is good result。All of thepatients were without elbow joint unstability and limition of Rom。Conclusion: Essex-Lopresti lesion seldom seen clinically and it demands earlydianosis and proper treatment。The standard for treatment is the reconstruction ofnormal length of radius and distal radio-ulnar joint stability。The main method is torestore normal length of radius using ORIF of radial head，But if radial head iscomminutionly fractured only，ORIF cannot be used，we can excise the radial head。Essex-Lopresti lesion with comminution radial head fractureThat cannot be used byORIF，The excision of radial head will be very drastic consequences。Distal radio-ulnarjoint must be addressed by early reduction and fixation。...