Central Band Interosseous Membrane Reconstruction For Forearm Longitudinal Instability

Abstract

Background The Essex-Lopresti injury results from injuries to the stabilizing structures of the forearm, the radial head, the interosseous membrane, and the triangular fibrocartilage complex.

Case Description/Literature Review We describe principles in approaching the patient with an acute or chronic Essex-Lopresti injury and describe surgical techniques to address these challenging cases both in the acute and chronic setting and describe outcomes of these techniques.

Clinical Relevance Further research into the role of the interosseous ligament in providing longitudinal and transverse stability to the forearm is likely to change our understanding of the Essex-Lopresti injury and alter management strategies.

Keywords

interosseous membrane reconstruction - forearm longitudinal instability - forearm - instability

• References

• 1 Trousdale RT, Osterman AL, Warhold L, Culp RW, Bednar JM. Reconstruction of the interosseous membrane using a bone-ligament-bone graft. American Society for Surgery of the Hand 52 ^nd Annual Meeting, Denver, CO. September 11–13, 1997.
• 2 Smith AM, Urbanosky LR, Castle JA, Rushing JT, Ruch DS. Radius pull test: predictor of longitudinal forearm instability. J Bone Joint Surg Am 2002; 84-A (11) 1970-1976
• 3 Pfaeffle HJ, Stabile KJ, Li ZM, Tomaino MM. Reconstruction of the interosseous ligament unloads metallic radial head arthroplasty and the distal ulna in cadavers. J Hand Surg Am 2006; 31 (2) 269-278
• 4 Pfaeffle HJ, Stabile KJ, Li ZM, Tomaino MM. Reconstruction of the interosseous ligament restores normal forearm compressive load transfer in cadavers. J Hand Surg Am 2005; 30 (2) 319-325
• 5 Tejwani M, Markolf KL, Benhaim P. Graft reconstruction of the interosseous membrane in conjunction with metallic radial head: a cadaveric study. J Hand Surg Am 2005; 30 (2) 335-342
• 6 Tomaino MM, Pfaeffle J, Stabile K, Li ZM. Reconstruction of the interosseous ligament of the forearm reduces load on the radial head in cadavers. J Hand Surg [Br] 2003; 28 (3) 267-270
• 7 Heijink A, Morrey BF, Cooney III WP. Radiocapitellar hemiarthroplasty for radiocapitellar arthritis: a report of three cases. J Shoulder Elbow Surg 2008; 17 (2) e12-e15
• 8 Failla JM, Jacobson J, van Holsbeeck M. Ultrasound diagnosis and surgical pathology of the torn interosseous membrane in forearm fractures/dislocations. J Hand Surg Am 1999; 24 (2) 257-266
• 9 Chloros GD, Wiesler ER, Stabile KJ, Papadonikolakis A, Ruch DS, Kuzma GR. Reconstruction of essex-lopresti injury of the forearm: technical note. J Hand Surg Am 2008; 33 (1) 124-130
• 10 Ruch DS, Chang DS, Koman LA. Reconstruction of longitudinal stability of the forearm after disruption of interosseous ligament and radial head excision (Essex-Lopresti lesion). J South Orthop Assoc 1999; 8 (1) 47-52
• 11 Drake ML, Farber GL, White KL, Parks BG, Segalman KA. Restoration of longitudinal forearm stability using a suture button construct. J Hand Surg Am 2010; 35 (12) 1981-1985
• 12 Gaspar MP, Kane PM, Pflug EM, Jacoby SM, Osterman AL, Culp RW. Interosseous Membrane Reconstruction with a Suture-Button Construct for Treatment of Chronic Forearm Instability. J Shoulder Elbow Surg 2016; In press
• 13 Adams JE, Culp RW, Osterman AL. Interosseous membrane reconstruction for the Essex-Lopresti injury. J Hand Surg Am 2010; 35 (1) 129-136
• 14 Osterman AL, Warhold L, Culp RW, Bednar JM. Reconstruction of the interosseous membrane using a bone-ligament-bone graft. American Society for Surgery of the Hand 52nd Annual Meeting. Denver, CO. September 11–13, 1997.
• 15 Essex-Lopresti P. Fractures of the radial head with distal radio-ulnar dislocation; report of two cases. J Bone Joint Surg Br 1951; 33B (2) 244-247
• 16 Werner F, Anderson A, Tucci E, Harley B. What provides transverse stability of the forearm?. J Wrist Surg 2015; 47: 4-24