Essex-Lopresti fracture

(Redirected from Essex Lopresti)

Background

Clinical Features

  • Unstable and painful forearm
  • Axial force from wrist to elbow after fall on outstretched hand
  • Grip weakness and difficulty pronating wrist

Differential Diagnosis

Elbow Diagnoses

Radiograph-Positive

Radiograph-Negative

Pediatric

Evaluation

Essex-Lopresti fracture with radial head fracture (left) and dorsal subluxation of the ulna (right).

Workup

Diagnosis

  • The injury can be difficult to diagnose initially, as the attention is focused on the injury to the radial head, leading to the distal radio-ulnar injury being overlooked.
  • The examination finding of tenderness of the distal radio-ulnar joint suggests an Essex-Lopresti injury in patients who have sustained high energy forearm trauma.
  • Plain radiography shows the radial head fracture, with dorsal subluxation of the ulna often seen on lateral view of the pronated wrist
  • Radial pull test: >3mm displacement dorsal/volar is consistent with Essex-Lopresti
  • May require CT to evaluate subtle fractures

Management

  • Orthopedic referral

Disposition

  • Per ortho - usually outpatient operative management (radial head arthroplasty)

See Also

External Links

References

Authors:

Ross Donaldson