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Essex-Lopresti Fracture
The Essex-Lopresti fracture is a fracture of the radial head of the forearm with concomitant dislocation of the distal radio-ulnar joint along with disruption of the thin interosseous membrane which holds them together.Essex Lopresti fracture
at Wheeless' Textbook of Orthopaedics online
The injury is named after Peter Essex-Lopresti who described it in 1951. Descriptive image link


Cause

This fracture typically occurs in patients who have fallen on an outstretched hand (a "FOOSH" injury).


Diagnosis

The injury can be difficult to diagnose initially as medical attention is usually focused on the injury to the radial head, leading to the distal radio-ulnar injury bein ...
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Bone Fracture
A bone fracture (abbreviated FRX or Fx, Fx, or #) is a medical condition in which there is a partial or complete break in the continuity of any bone in the body. In more severe cases, the bone may be broken into several fragments, known as a ''comminuted fracture''. A bone fracture may be the result of high force impact or stress, or a minimal trauma injury as a result of certain medical conditions that weaken the bones, such as osteoporosis, osteopenia, bone cancer, or osteogenesis imperfecta, where the fracture is then properly termed a pathologic fracture. Signs and symptoms Although bone tissue contains no pain receptors, a bone fracture is painful for several reasons: * Breaking in the continuity of the periosteum, with or without similar discontinuity in endosteum, as both contain multiple pain receptors. * Edema and hematoma of nearby soft tissues caused by ruptured bone marrow evokes pressure pain. * Involuntary muscle spasms trying to hold bone fragments in pla ...
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Head Of Radius
The head of the radius has a cylindrical form, and on its upper surface is a shallow cup or fovea for articulation with the capitulum of the humerus. The circumference of the head is smooth; it is broad medially where it articulates with the radial notch of the ulna, narrow in the rest of its extent, which is embraced by the annular ligament.''Gray's Anatomy'' (1918), see infobox Articular surfaces The head of the radius is shaped to articulate with a complex of articular surfaces during both flexion-extension at the elbow and supination-pronation in the forearm: Humeroradial joint The head's proximal surface is concave and cup-shaped to correspond to the spherical surface of the capitulum of the humerus. The radius can thus glide on the capitulum during elbow flexion-extension while simultaneously rotate about its own main axis during supination-pronation. Between the capitulum and the trochlea of the humerus is the capitulotrochlear groove. A semi-lunar surface around the ...
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Distal Radioulnar Articulation
The distal radioulnar articulation (also known as the distal radioulnar joint, or inferior radioulnar joint) is a synovial pivot joint between the two bones in the forearm; the radius and ulna. It is one of two joints between the radius and ulna, the other being the proximal radioulnar articulation. The joint features an articular disc, and is reinforced by the palmar and dorsal radioulnar ligaments. Structure The distal radioulnar articulation is formed by the head of ulna, and the ulnar notch of the distal radius. Articular disc The joint features a triangular articular disc that is attached to the inferior margin of the ulnar notch by its base, and to a fossa at the base of the styloid process of the ulna by its apex. The articular disc acts to firmly bind the distal extremities of the two bones together. Ligaments The articulation is reinforced by the palmar radioulnar ligament, and dorsal radioulnar ligament. Function The function of the radioulnar joint is ...
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Interosseous Membrane Of The Forearm
The interosseous membrane of the forearm (rarely middle or intermediate radioulnar joint) is a fibrous sheet that connects the interosseous margins of the radius and the ulna. It is the main part of the radio-ulnar syndesmosis, a fibrous joint between the two bones. Function The interosseous membrane divides the forearm into anterior and posterior compartments, serves as a site of attachment for muscles of the forearm, and transfers loads placed on the forearm. The interosseous membrane is designed to shift compressive loads (as in doing a hand-stand) from the distal radius to the proximal ulna. The fibers within the interosseous membrane are oriented obliquely so that when force is applied the fibers are drawn taut, shifting more of the load to the ulna. This reduces the wear and tear of placing the whole load on a single joint. The role of the membrane in load shifting is illustrated when the interosseous membrane is cut; the forces on each bone equalize from their natural pro ...
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Peter Essex-Lopresti
Peter Gordon Lawrence Essex-Lopresti FRCS Ed. (1916 – 13 June 1951) was a British orthopaedic surgeon remembered for describing the Essex-Lopresti fracture and for his work on classification and treatment of fractures of the calcaneus. Biography Peter Essex-Lopresti trained at the London Hospital, qualifying in 1937. He joined the Royal Army Medical Corps, serving as surgical specialist in an airborne division during World War II. He published a report on the injuries sustained during over 20,000 parachute jumps made by the Sixth British Airborne Division, and followed this with a paper on the open wound in trauma. After the war he worked as a consultant surgeon at the Birmingham Accident Hospital Birmingham Accident Hospital, formerly known as Birmingham Accident Hospital and Rehabilitation Centre, was established in April 1941 as Birmingham's response to two reports, the British Medical Association's Committee on Fractures (1935) and th ..., where he reorganized th ...
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Subluxation
A subluxation is an incomplete or partial dislocation of a joint or organ. According to the World Health Organization (WHO), a subluxation is a "significant structural displacement", and is therefore always visible on static imaging studies, such as X-rays. In contrast, the chiropractic belief of "vertebral subluxation" may or may not involve a significant displacement or even pain or clear dysfunction.WHO guidelines on basic training and safety in chiropractic
p. 4, including footnote.


Joints


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Ulna
The ulna (''pl''. ulnae or ulnas) is a long bone found in the forearm that stretches from the elbow to the smallest finger, and when in anatomical position, is found on the medial side of the forearm. That is, the ulna is on the same side of the forearm as the little finger. It runs parallel to the radius, the other long bone in the forearm. The ulna is usually slightly longer than the radius, but the radius is thicker. Therefore, the radius is considered to be the larger of the two. Structure The ulna is a long bone found in the forearm that stretches from the elbow to the smallest finger, and when in anatomical position, is found on the medial side of the forearm. It is broader close to the elbow, and narrows as it approaches the wrist. Close to the elbow, the ulna has a bony process, the olecranon process, a hook-like structure that fits into the olecranon fossa of the humerus. This prevents hyperextension and forms a hinge joint with the trochlea of the humerus. Ther ...
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Pronation
Motion, the process of movement, is described using specific anatomical terms. Motion includes movement of organs, joints, limbs, and specific sections of the body. The terminology used describes this motion according to its direction relative to the anatomical position of the body parts involved. Anatomists and others use a unified set of terms to describe most of the movements, although other, more specialized terms are necessary for describing unique movements such as those of the hands, feet, and eyes. In general, motion is classified according to the anatomical plane it occurs in. ''Flexion'' and ''extension'' are examples of ''angular'' motions, in which two axes of a joint are brought closer together or moved further apart. ''Rotational'' motion may occur at other joints, for example the shoulder, and are described as ''internal'' or ''external''. Other terms, such as ''elevation'' and ''depression'', describe movement above or below the horizontal plane. Many anatom ...
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Open Reduction Internal Fixation
Internal fixation is an operation in orthopedics that involves the surgical implementation of implants for the purpose of repairing a bone, a concept that dates to the mid-nineteenth century and was made applicable for routine treatment in the mid-twentieth century. An internal fixator may be made of stainless steel, titanium alloy, or cobalt-chrome alloy. or plastics. Types of internal fixators include: * Plate and screws * Kirschner wires * Intramedullary nails Open reduction Open Reduction Internal Fixation (ORIF) involves the implementation of implants to guide the healing process of a bone, as well as the open reduction, or setting, of the bone. ''Open reduction'' refers to open surgery to set bones, as is necessary for some fractures. ''Internal fixation'' refers to fixation of screws and/or plates, intramedullary rods and other devices to enable or facilitate healing. Rigid fixation prevents micro-motion across lines of fracture to enable healing and prevent infe ...
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Anatomical Terms Of Location
Standard anatomical terms of location are used to unambiguously describe the anatomy of animals, including humans. The terms, typically derived from Latin or Greek roots, describe something in its standard anatomical position. This position provides a definition of what is at the front ("anterior"), behind ("posterior") and so on. As part of defining and describing terms, the body is described through the use of anatomical planes and anatomical axes. The meaning of terms that are used can change depending on whether an organism is bipedal or quadrupedal. Additionally, for some animals such as invertebrates, some terms may not have any meaning at all; for example, an animal that is radially symmetrical will have no anterior surface, but can still have a description that a part is close to the middle ("proximal") or further from the middle ("distal"). International organisations have determined vocabularies that are often used as standard vocabularies for subdisciplines of ...
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Supination
Motion, the process of movement, is described using specific anatomical terms. Motion includes movement of organs, joints, limbs, and specific sections of the body. The terminology used describes this motion according to its direction relative to the anatomical position of the body parts involved. Anatomists and others use a unified set of terms to describe most of the movements, although other, more specialized terms are necessary for describing unique movements such as those of the hands, feet, and eyes. In general, motion is classified according to the anatomical plane it occurs in. ''Flexion'' and ''extension'' are examples of ''angular'' motions, in which two axes of a joint are brought closer together or moved further apart. ''Rotational'' motion may occur at other joints, for example the shoulder, and are described as ''internal'' or ''external''. Other terms, such as ''elevation'' and ''depression'', describe movement above or below the horizontal plane. Many anatom ...
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Malunion
A malunion is when a fractured bone does not heal properly. Some ways that it shows is by having the bone being twisted, shorter, or bent. Malunions can occur by having the bones improperly aligned when immobilized, having the cast taken off too early, or never seeking medical treatment after the break. Malunions are painful and commonly produce swelling around the area, possible immobilization, and deterioration of the bone and tissue. Signs and symptoms Malunions are presented by excessive swelling, twisting, bending, and possibly shortening of the bone. Patients may have trouble placing weight on or near the malunion. Diagnosis An X-ray is essential for the proper diagnosis of a malunion. The doctor will look into the patient’s history and the treatment process for the bone fracture. Oftentimes a CT scan and probably an MRI are also used in diagnosis. MRI are used to check of cartilage and ligament issues that developed due to the malunion and misalignment. CT scans ...
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