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CC BY-NC-ND 4.0 · Revista Iberoamericana de Cirugía de la Mano 2019; 47(01): 065-074
DOI: 10.1055/s-0039-1688707
Update Article | Artículo de Actualización
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Lesión de Essex-Lopresti: Diagnóstico y Tratamiento

Essex-Lopresti Injury: Diagnosis and Treatment
Fernando García de Lucas 
1   Servicio de Cirugía Ortopédica y Traumatología, Hospital FREMAP de Majadahonda, Madrid, Spain
,
Guillermo F. García Ruiz-Calero
2   Servico de Médicina Física y Rehabilitación, Hospital Central de la Defensa “Gómez Ulla,” Madrid, Spain
› Author Affiliations
Further Information

Publication History

27 March 2019

08 April 2019

Publication Date:
10 June 2019 (online)

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Resumen

Definición La lesión de Essex-Lopresti combina una fractura de la cabeza del radio, la rotura longitudinal de la membrana interósea y de los elementos estabilizadores de la articulación radiocubital distal, y funcionalmente equivale a una inestabilidad radiocubital longitudinal.

Diagnóstico Su baja incidencia y la sintomatología centrada alrededor de la fractura de cabeza de radio hace que, a menudo no se diagnostique en la fase aguda y acabe cronificándose. El diagnóstico requiere una evaluación clínica y pruebas de imagen de todo el antebrazo.

Tratamiento Las premisas en el tratamiento son restablecer la anatomía y restituir la biomecánica del antebrazo para lo que es imprescindible conservar o sustituir la cabeza del radio y favorecer la cicatrización de los elementos estabilizadores de la articulación radiocubital distal. A pesar de que puede haber menos consenso en cuanto a la capacidad de cicatrización y la reconstrucción de la membrana interósea, se obtienen mejores resultados clínicos cuando se lleva a cabo su reconstrucción. La utilización de una prótesis total de la articulación radiocubital distal combinada con la fijación interna o una prótesis de cabeza de radio simplifica el tratamiento y los resultados obtenidos hasta el momento son prometedores.

Abstract

Definition The Essex-Lopresti injury combines a fracture of radial head, longitudinal disruption of the interosseous membrane and of the stabilizing elements of the distal radioulnar joint and functionally equivalent to a longitudinal radioulnar dissociation.

Diagnosis Its low incidence and the symptomatology centered around the radial head fracture means that it is not commonly diagnosed in the acute phase and ends up becoming chronic. Diagnosis requires a clinical evaluation and image tests of the entire forearm.

Treatment Premises in the treatment are to restore the anatomy and the biomechanic of the forearm for which it is essential to preserve or replace the head of the radius and favor the healing of the stabilizing elements of the distal radioulnar joint. Although there may be less consensus regarding the healing capacity and the reconstruction of the interosseous membrane, better clinical results are obtained when reconstruction is carried out. The use of a total prosthesis of the distal radioulnar joint combined with internal fixation or a radio head prosthesis simplifies the treatment and the results obtained so far are promising.

Palabras clave

cabeza de radio - membrana interósea - articulación radiocubital distal - reparación - reconstrucción

Keywords

radial head - interosseus membrane - distal radioulnar joint - repair - reconstruction
 

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