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Chronic Essex-Lopresti injury: a systematic review of current treatment options

  • Stefano Artiaco
  • Federico Fusini
  • Giulia Colzani
  • Alessandro Massè
  • Bruno Battiston
Review Article

Abstract

Introduction

Essex-Lopresti lesion (ELL) is a severe injury. Most of ELL is recognized in chronic phase representing a therapeutic challenge for orthopaedic surgeons. The aim of this systematic review is to highlight and criticize current concepts in the surgical treatment.

Materials and methods

The search was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guideline. A comprehensive research of Pubmed database was made using the following Mesh term: ((Essex-Lopresti injury) OR (Essex Lopresti) OR (distal radio ulnar dissociation) OR (distal radio ulnar dislocation) OR (longitudinal forearm instability)). Quality assessment of each article was performed according to Coleman score by two authors.

Results

Eight full articles were included to the systematic review. Surgical treatment was differentiated in five categories according to the most common procedure reported in clinical series. The mean Coleman Score was 51.13 ± 9.76.

Discussion

Case series reported in the literature include a limited number of patients with chronic ELL. Currently, salvage procedure devoted to treat a wrong diagnosis and an incorrect treatment is used. Radial head replacement together with ulnar shortening osteotomy and interosseous membrane reconstruction are the most common treatments of choice, but at present, there is not yet a shared scheme of management for patients with chronic ELL.

Conclusions

According to current literature, a case-by-case treatment must always be considered. Further investigations, with higher level of evidence, quality of study design, and number of patients, are needed to better assess clinical results and complication of each technique.

Level of evidence:

IV.

Keywords

Radial head fractures TFCC injury Interosseous membrane injury Longitudinal forearm instability 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

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Copyright information

© SICOT aisbl 2018

Authors and Affiliations

  1. 1.Department of Orthopaedics and Traumatology, Orthopaedic and Trauma CenterAzienda Ospedaliero Universitaria Città della Salute e della Scienza di TorinoTorinoItaly
  2. 2.Department of Orthopaedics and Traumatology, Policlinico di ModenaAzienda Ospedaliera UniversitariaModenaItaly

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