Surgical Treatment of Chronic Essex-Lopresti Lesion: Interosseous Membrane Reconstruction and Radial Head Prosthesis

Abstract

The Essex-Lopresti lesion, or radioulnar longitudinal dissociation, results from an axial load to the forearm with lesion to the radial head, interosseous membrane and distal radioulnar joint. The lesion is rarely diagnosed early, therefore treatment is often subacute or chronic. In these cases, procedures such as radial head replacement, ulnar shortening and/or wafer procedures should be combined with reconstruction of the interosseous membrane central band to restore longitudinal stability of the forearm. In the technique described, we use a folded fascia lata allograft fixed with specific device throughout transulnar and transradial tunnels passed through dorsal soft tissue access. The graft tension is progressively addressed with the help of fixation device. It seems an easily surgical technique without donor site morbidity.