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A Novel Algorithmic Approach to Chronic Forearm Longitudinal Instability

Rubin, Todd A., MD; Gluck, Matthew J., BS; Hausman, Michael R., MD

Techniques in Hand & Upper Extremity Surgery: September 2018 - Volume 22 - Issue 3 - p 81–88
doi: 10.1097/BTH.0000000000000195

Essex-Lopresti Lesions are rare injuries that are often missed in the acute setting. Delayed intervention may lead to chronic wrist and elbow pain and overall poor outcomes. The literature currently supports treatments that involve shortening of the ulna to reduce the relative degree of ulnar impaction, followed by attempted reduction of the distal radioulnar joint. Although such techniques may help to temporarily reduce wrist pain secondary to ulnar impaction, they do not address the proximal migration of the radius and ipsilateral radial head dislocation at the elbow. Subsequent procedures are often needed to replace or resect the radial head. We present a novel approach to chronic Essex-Lopresti lesions resulting in anatomic restoration of forearm length with return of elbow and wrist flexion/extension as well as improved forearm pronation/supination.

Leni & Peter W. May Department of Orthopaedic Surgery, Mount Sinai Hospital, New York, NY

Conflicts of Interest and Source of Funding: Supported by the Leni & Peter W. May Department of Orthopaedic Surgery at Mount Sinai Hospital. The authors report no conflicts of interest.

Address correspondence and reprint requests to Matthew J. Gluck, BS, Mount Sinai Hospital, 1 Gustave Levy Place, New York, NY 10029. E-mail:

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