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Muacevic A, Adler JR, Charalampus H, Athanasiou V, Panagopoulos A, Kokkalis Z. Elbow Dislocation With Associated Essex-Lopresti Injury: A Case Treated Conservatively. Cureus 2022; 14:e32099. [PMID: 36601210 PMCID: PMC9805318 DOI: 10.7759/cureus.32099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2022] [Indexed: 12/03/2022] Open
Abstract
A 23-year-old woman suffered a posterior elbow dislocation, distal radius intraarticular fracture, distal radioulnar joint subluxation, and coronoid process fracture, suggesting an Essex-Lopresti injury variant. Closed reduction for the elbow dislocation was performed, and the limb was immobilized at a 90-degree angle with the forearm in a neutral position with a long posterior splint. Three months later complete fracture healing was noted radiologically. One year post-injury full range of motion regarding flexion, pronation, and supination was achieved with only 10 degrees of extension deficit remaining, suggesting a case of Essex-Lopresti injury managed conservatively with excellent results.
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An Unusual Terrible Triad Variant Associated with an Essex-Lopresti Injury. Case Rep Orthop 2021; 2021:8522303. [PMID: 34580615 PMCID: PMC8464426 DOI: 10.1155/2021/8522303] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 06/22/2021] [Accepted: 08/27/2021] [Indexed: 11/18/2022] Open
Abstract
Essex-Lopresti injuries and terrible triad injuries of the elbow are rare injuries that typically result from high-energy trauma such as falling from a height or a motor vehicle collision. However, the combination of an Essex-Lopresti injury and terrible triad injury is unique and poses a significant challenge for treatment as these injuries are independently associated with poor functional outcomes if they are not acutely diagnosed. We describe a case of a 19-year-old who presented with an unusual variant of a terrible triad injury associated with an Essex-Lopresti injury. The patient had a distal radioulnar joint (DRUJ) and elbow dislocation, a radial head and coronoid process fracture, and a distal radius fracture. Almost a reverse Essex-Lopresti, this injury was successfully managed with open reduction and repair of the distal radius, radial head, and damaged ligaments in the elbow, along with an internal joint stabilizer (IJS).
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Artiaco S, Fusini F, Sard A, Dutto E, Massè A, Battiston B. Fracture-dislocations of the forearm joint: a systematic review of the literature and a comprehensive locker-based classification system. J Orthop Traumatol 2020; 21:21. [PMID: 33263862 PMCID: PMC7710780 DOI: 10.1186/s10195-020-00562-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 11/25/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Monteggia, Galeazzi, and Essex-Lopresti injuries are the most common types of fracture-dislocation of the forearm. Uncommon variants and rare traumatic patterns of forearm fracture-dislocations have sometimes been reported in literature. In this study we systematically review the literature to identify and classify all cases of forearm joint injury pattern according to the forearm joint and three-locker concepts. METHODS A comprehensive search of the PubMed database was performed based on major pathological conditions involving fracture-dislocation of the forearm. Essex-Lopresti injury, Monteggia and Galeazzi fracture-dislocations, and proximal and/or distal radioulnar joint dislocations were sought. After article retrieval, the types of forearm lesion were classified using the following numerical algorithm: proximal forearm joint 1 [including proximal radioulnar joint (PRUJ) dislocation with or without radial head fractures], middle radioulnar joint 2, if concomitant radial fracture R, if concomitant interosseous membrane rupture I, if concomitant ulnar fracture U, and distal radioulnar joint 3 [including distal radioulnar joint (DRUJ) dislocation with or without distal radial fractures]. RESULTS Eighty hundred eighty-four articles were identified through PubMed, and after bibliographic research, duplication removal, and study screening, 462 articles were selected. According to exclusion criteria, 44 full-text articles describing atypical forearm fracture-dislocation were included. Three historical reviews were added separately to the process. We detected rare patterns of two-locker injuries, sometimes referred to using improper terms of variant or equivalent types of Monteggia and Galeazzi injuries. Furthermore, we identified a group of three-locker injuries, other than Essex-Lopresti, associated with ulnar and/or radial shaft fracture causing longitudinal instability. In addition to fracture-dislocations commonly referred to using historical eponyms (Monteggia, Galeazzi, and Essex-Lopresti), our classification system, to the best of the authors' knowledge, allowed us to include all types of dislocation and fracture-dislocation of the forearm joint reported in literature. According to this classification, and similarly to that of the elbow, we could distinguish between simple dislocations and complex dislocations (fracture-dislocations) of the forearm joint. CONCLUSIONS All injury patterns may be previously identified using an alphanumeric code. This might avoid confusion in forearm fracture-dislocations nomenclature and help surgeons with detection of lesions, guiding surgical treatment. LEVEL OF EVIDENCE V.
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Affiliation(s)
- Stefano Artiaco
- Department of Orthopaedic and Traumatology, Hand and Microsurgery Unit, Orthopaedic and Trauma Centre, AOU Città Della Salute E Della Scienza Di Torino, via Zuretti 29, 10126 Turin, Italy
| | - Federico Fusini
- Department of Orthopaedic and Traumatology, Orthopaedic and Trauma Centre, AOU Città Della Salute E Della Scienza Di Torino, University of Turin, via Zuretti 29, 10126 Turin, Italy
| | - Arman Sard
- Department of Orthopaedic and Traumatology, Hand and Microsurgery Unit, Orthopaedic and Trauma Centre, AOU Città Della Salute E Della Scienza Di Torino, via Zuretti 29, 10126 Turin, Italy
| | - Elisa Dutto
- Department of Orthopaedic and Traumatology, Hand and Microsurgery Unit, Orthopaedic and Trauma Centre, AOU Città Della Salute E Della Scienza Di Torino, via Zuretti 29, 10126 Turin, Italy
| | - Alessandro Massè
- Department of Orthopaedic and Traumatology, Orthopaedic and Trauma Centre, AOU Città Della Salute E Della Scienza Di Torino, University of Turin, via Zuretti 29, 10126 Turin, Italy
| | - Bruno Battiston
- Department of Orthopaedic and Traumatology, Hand and Microsurgery Unit, Orthopaedic and Trauma Centre, AOU Città Della Salute E Della Scienza Di Torino, via Zuretti 29, 10126 Turin, Italy
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Logli AL, Pulos N. Problems of Eponymous Proportions: The History Behind Recognizing Forearm Instability Issues. Hand Clin 2020; 36:397-406. [PMID: 33040952 DOI: 10.1016/j.hcl.2020.07.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Three predictable patterns of forearm fracture-dislocation-Essex-Lopresti, Monteggia, and Galeazzi-can occur and are eponymously labeled for the investigators who appreciated their unique characteristics and offered a framework by which to understand them. Recognition of these injuries and subsequent investigation and increased understanding of these lesions have resulted in improved understanding about forearm anatomy and stability. Management of the component of instability differs based on the type of fracture-dislocation, the timing of intervention, and surgeon preference. Despite advances in understanding and treating these injuries, nuances of these lesions may remain challenging to modern-day surgeons.
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Affiliation(s)
- Anthony L Logli
- Department of Orthopedic Surgery, Mayo Clinic, 200 1st Street Southwest, Rochester, MN 55905, USA. https://twitter.com/AnthonyLogliMD
| | - Nicholas Pulos
- Department of Orthopedic Surgery, Mayo Clinic, 200 1st Street Southwest, Rochester, MN 55905, USA.
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Stabilization of the radial head with the palmaris longus or the gracilis tendon: an anatomical feasibility study. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY 2020; 31:651-659. [PMID: 33098459 DOI: 10.1007/s00590-020-02815-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 10/15/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE The proximal radioulnar joint (PRUJ) and the radiocapitellar joint may be destabilized after trauma. Different techniques for stabilization of PRUJ have been proposed, but none of them can stabilize the radiocapitellar joint at the same time. We propose a ligamentoplasty to stabilize the radial head at these two joints by reconstructing the radial head annular ligament and the lateral collateral ulnar ligament (LCUL) with a single graft (palmaris longus or gracilis tendon of the knee). METHODS Fifteen cadaveric upper limbs were used to compare the stabilization obtained by performing our ligamentoplasty with the palmaris longus or the gracilis tendon. For each technique, the stabilization obtained was evaluated by measuring the displacement of the radial head in the anterior, lateral and posterior directions when a force of 1 N was applied in maximum supination, neutral rotation and maximum pronation. We also evaluated whether this technique could damage the ulnar nerve or the posterior interosseous nerve by dissecting them and whether it could limit the range of rotation of the forearm. RESULTS Our ligamentoplasty enables to restore PRUJ stability equivalent to the intact ligament condition. The palmaris longus was inconstant (13/15) and too short to allow concomitant reconstruction of the LCUL (except in one case). No nerve damage was found during the dissection, and the range of rotation of the forearm was not limited by the ligamentoplasty. We also report a clinical case with an excellent result and without complications. CONCLUSION This ligamentoplasty we have described makes it possible to stabilize the radial head with respect to the radial notch of the ulna and with respect to the capitellum of the humerus. The gracilis tendon is more suitable than the palmaris longus because of its constant presence and length. A clinical series is now necessary to better evaluate this technique.
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Andreotti M, Tonon F, Caruso G, Massari L, Riva MA. The "Chauffeur Fracture": Historical Origins of an Often-Forgotten Eponym. Hand (N Y) 2020; 15:252-254. [PMID: 30079762 PMCID: PMC7076623 DOI: 10.1177/1558944718792650] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This article describes the origin of the term "chauffeur fracture" used to indicate an oblique fracture of the radial styloid process with extension into the wrist joint. This kind of fracture was originally described by the British surgeon Jonathan Hutchinson in 1866. The invention of the automobile increased the incidence of this fracture among chauffeurs and cabdrivers. Indeed, at the beginning of the 20th century, motor vehicles were started by means of a crank-handle connected to the engine, which needed to be turned vigorously clockwise by hand. If the motor started unexpectedly, the crank-handle could jerk back violently and thereby cause a wrist injury due to sudden hyperextension. We retrospectively reviewed the literature and historical articles to better define the historical origins of an often-forgotten eponym. In 1904, the French surgeon Just Lucas-Championnière first evidenced the occupational origin of this fracture, so introducing the term "chauffeur fracture" to identify this injury.
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Affiliation(s)
- Mattia Andreotti
- Department of Morphology, Experimental Medicine and Surgery, Azienda Ospedaliero-Universitaria di Ferrara – Arcispedale Sant’Anna, University of Ferrara, Italy
| | - Francesco Tonon
- Department of Morphology, Experimental Medicine and Surgery, Azienda Ospedaliero-Universitaria di Ferrara – Arcispedale Sant’Anna, University of Ferrara, Italy,Francesco Tonon, Department of Morphology, Experimental Medicine and Surgery, Azienda Ospedaliero-Universitaria S.Anna, University of Ferrara, via Aldo Moro 8, Ferrara 44124, Italy.
| | - Gaetano Caruso
- Department of Biomedical and Specialty Surgical Sciences, Azienda Ospedaliero-Universitaria di Ferrara – Arcispedale Sant’Anna, University of Ferrara, Italy
| | - Leo Massari
- Department of Biomedical and Specialty Surgical Sciences, Azienda Ospedaliero-Universitaria di Ferrara – Arcispedale Sant’Anna, University of Ferrara, Italy
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Elzinga K, Chung K. Evolution of the Ring Concept for the Forearm and Its Implication on Treatment: From Galeazzi, Monteggia, Essex-Lopresti, and Darrach to the Current Era. J Hand Surg Asian Pac Vol 2019; 24:251-257. [PMID: 31438785 DOI: 10.1142/s2424835519300019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Geometrically, rings distribute their stress along their arc instead of concentrating at any one point. The forearm ring is composed of the radius, ulna, proximal radioulnar joint, and distal radioulnar joint. The annular ligament, interosseous membrane, and triangular fibrocartilage complex link and stabilize the ring. Injuries to the forearm occur along a continuum with recognized patterns of ring disruption, including Galeazzi, Monteggia, and Essex-Lopresti injuries. The Darrach procedure causes a disruption to the forearm ring and can lead to painful convergence between the radius and distal ulnar stump. Injuries to the forearm ring are unstable. Management of forearm injuries is centered on the restoration of the anatomy and stability of the forearm ring. Forearm ring injuries and their treatment are discussed in this article.
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Affiliation(s)
- Kate Elzinga
- Section of Plastic Surgery, University of Calgary, South Health Campus, Calgary, AB, Canada
| | - Kevin Chung
- Section of Plastic Surgery, The University of Michigan Health System, Ann Arbor, MI, USA
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8
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An uncommon variant of the Essex-Lopresti injury. Skeletal Radiol 2018; 47:397-400. [PMID: 28971244 DOI: 10.1007/s00256-017-2782-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 09/11/2017] [Accepted: 09/19/2017] [Indexed: 02/02/2023]
Abstract
The Essex-Lopresti injury is an extremely rare condition combining radial head or neck fracture, distal radio-ulnar joint dislocation and rupture of the interosseous membrane. However, there are rare or unusual varieties or associated injuries. We report a case of a 46-year-old woman with a posterior dislocation of the radio-humeral joint, a radial shaft fracture, and a distal radio-ulnar joint dislocation. She underwent open reduction and internal fixation of the radial shaft fracture followed by an immobilization by a long elbow splint in supination for 6 weeks. At 18 months of follow-up, she was asymptomatic and she had a full range of elbow and wrist motion and had resumed thoroughly her previous job. The Essex-Lopresti injury results from a complex injury to the forearm axis with resultant longitudinal instability, which can be challenging to treat. There are some variations that can lead to a missed diagnosis resulting in persistent pain and instability of the wrist. The best outcomes are reached with early diagnosis and prompt management.
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Laumonerie P, Reina N, Ancelin D, Delclaux S, Tibbo ME, Bonnevialle N, Mansat P. Mid-term outcomes of 77 modular radial head prostheses. Bone Joint J 2017; 99-B:1197-1203. [PMID: 28860400 DOI: 10.1302/0301-620x.99b9.bjj-2016-1043.r2] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 04/03/2017] [Indexed: 11/05/2022]
Abstract
AIMS Radial head arthroplasty (RHA) may be used in the treatment of non-reconstructable radial head fractures. The aim of this study was to evaluate the mid-term clinical and radiographic results of RHA. PATIENTS AND METHODS Between 2002 and 2014, 77 RHAs were implanted in 54 men and 23 women with either acute injuries (54) or with traumatic sequelae (23) of a fracture of the radial head. Four designs of RHA were used, including the Guepar (Small Bone Innovations (SBi)/Stryker; 36), Evolutive (Aston Medical; 24), rHead RECON (SBi/Stryker; ten) or rHead STANDARD (SBi/Stryker; 7) prostheses. The mean follow-up was 74.0 months (standard deviation (sd) 38.6; 24 to 141). The indication for further surgery, range of movement, mean Mayo Elbow Performance (MEP) score, quick Disabilities of the Arm, Shoulder and Hand (quickDASH) score, osteolysis and positioning of the implant were also assessed according to the design, and acute or delayed use. RESULTS The mean MEP and quickDASH scores were 90.2 (sd 14; 45 to 100), and 14.0 points (sd 12; 1.2 to 52.5), respectively. There were no significant differences between RHA performed in acute or delayed fashion. There were 30 re-operations (19 with, and 11 without removal of the implant) during the first three post-operative years. Painful loosening was the primary indication for removal in 14 patients. Short-stemmed prostheses (16 mm to 22 mm in length) were also associated with an increased risk of painful loosening (odds ratio 3.54 (1.02 to 12.2), p = 0.045). Radiocapitellar instability was the primary indication for re-operation with retention of the implant (5). The overall survival of the RHA, free from re-operation, was 60.8% (sd 5.7%) at ten years. CONCLUSION Bipolar and press-fit RHA gives unsatisfactory mid-term outcomes in the treatment of acute fractures of the radial head or their sequelae. The outcome may vary according to the design of the implant. The rate of re-operation during the first three years is predictive of the long-term survival in tight-fitting RHAs. Cite this article: Bone Joint J 2017;99-B1197-1203.
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Affiliation(s)
- P Laumonerie
- Hôpital Pierre-Paul Riquet, Place du Docteur Baylac, Toulouse 31059, France
| | - N Reina
- Hôpital Pierre-Paul Riquet, Place du Docteur Baylac, Toulouse 31059, France
| | - D Ancelin
- Hôpital Pierre-Paul Riquet, Place du Docteur Baylac, Toulouse 31059, France
| | - S Delclaux
- Hôpital Pierre-Paul Riquet, Place du Docteur Baylac, Toulouse 31059, France
| | - M E Tibbo
- Hôpital Pierre-Paul Riquet, Place du Docteur Baylac, Toulouse 31059, France
| | - N Bonnevialle
- Hôpital Pierre-Paul Riquet, Place du Docteur Baylac, Toulouse 31059, France
| | - P Mansat
- Hôpital Pierre-Paul Riquet, Place du Docteur Baylac, Toulouse 31059, France
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Soubeyrand M, Assabah B, Bégin M, Laemmel E, Dos Santos A, Crézé M. Pronation and supination of the hand: Anatomy and biomechanics. HAND SURGERY & REHABILITATION 2017; 36:2-11. [DOI: 10.1016/j.hansur.2016.09.012] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 08/29/2016] [Accepted: 09/01/2016] [Indexed: 11/15/2022]
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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; 25:1491-500. [PMID: 27374233 DOI: 10.1016/j.jse.2016.04.018] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 04/12/2016] [Accepted: 04/16/2016] [Indexed: 02/01/2023]
Abstract
BACKGROUND The purpose of this study was to report outcomes of interosseous membrane (IOM) reconstruction with a suture-button construct for treatment of chronic longitudinal forearm instability. METHODS We performed a retrospective review with prospective follow-up of patients who underwent ulnar shortening osteotomy and IOM reconstruction with the Mini TightRope device from 2011 through 2014. Bivariate statistical analysis was used for comparison of preoperative and postoperative Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) scores, range of motion, grip strength, and ulnar variance. Complications and patient satisfaction were also recorded. RESULTS Ten patients (mean age, 45.3 years) satisfied inclusion criteria: 8 treated for post-traumatic sequelae of Essex-Lopresti-type injuries, 1 for forearm instability secondary to previous elbow surgery, and 1 for instability secondary to trauma and multiple elbow surgeries. Surgeries were performed an average of 28.6 months from initial injury. At mean follow-up of 34.6 months after surgery, significant improvement was observed in elbow flexion-extension arc (+23° vs. preoperatively; P = .007), wrist flexion-extension arc (+22°; P = .016), QuickDASH score (-48; P = .000), and ulnar variance (-3.3 mm; P = .006). Three patients required additional surgery: 1 revision ulnar shortening osteotomy for persistent impingement, 1 revision ulnar osteotomy and Mini TightRope removal for lost forearm supination, and 1 fixation of a radial shaft fracture after a fall. CONCLUSION IOM reconstruction using a suture-button construct is an effective treatment option for chronic forearm instability.
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Affiliation(s)
- Michael P Gaspar
- The Philadelphia Hand Center, P.C., Philadelphia, PA, USA; Department of Orthopedic Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
| | - Patrick M Kane
- The Philadelphia Hand Center, P.C., Philadelphia, PA, USA; Department of Orthopedic Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - Emily M Pflug
- The Philadelphia Hand Center, P.C., Philadelphia, PA, USA
| | - Sidney M Jacoby
- The Philadelphia Hand Center, P.C., Philadelphia, PA, USA; Department of Orthopedic Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - A Lee Osterman
- The Philadelphia Hand Center, P.C., Philadelphia, PA, USA; Department of Orthopedic Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - Randall W Culp
- The Philadelphia Hand Center, P.C., Philadelphia, PA, USA; Department of Orthopedic Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA
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Wong PKW, Hanna TN, Shuaib W, Sanders SM, Khosa F. What's in a name? Upper extremity fracture eponyms (Part 1). Int J Emerg Med 2015. [PMID: 26223984 PMCID: PMC4519440 DOI: 10.1186/s12245-015-0075-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Eponymous extremity fractures are commonly encountered in the emergency setting. Correct eponym usage allows rapid, succinct communication of complex injuries. We will review both common and less frequently encountered extremity fracture eponyms, focusing on imaging features to identify and differentiate these injuries. We focus on plain radiographic findings, with supporting computed tomography (CT) images. For each injury, important radiologic descriptors are discussed which may need to be communicated to consultants. Aspects of management and follow-up imaging recommendations are included. This is a two-part review: Part 1 focuses on fracture eponyms of the upper extremity, while Part 2 covers fracture eponyms of the lower extremity.
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Affiliation(s)
- Philip Kin-Wai Wong
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1364 Clifton Road, Atlanta, GA, 30322, USA,
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13
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Veith NT, Knopp W, Pizanis A, Tschernig T, Pohlemann T, Mörsdorf P. [Not Available]. Chirurg 2015; 87:162-4. [PMID: 26016712 DOI: 10.1007/s00104-015-0025-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- N T Veith
- Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universität des Saarlandes, Kirrberger Straße 1, 66421, Homburg/Saar, Deutschland.
| | - W Knopp
- Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universität des Saarlandes, Kirrberger Straße 1, 66421, Homburg/Saar, Deutschland
| | - A Pizanis
- Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universität des Saarlandes, Kirrberger Straße 1, 66421, Homburg/Saar, Deutschland
| | - T Tschernig
- Institut für Anatomie und Zellbiologie, Universität des Saarlandes, 66421, Homburg, Deutschland
| | - T Pohlemann
- Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universität des Saarlandes, Kirrberger Straße 1, 66421, Homburg/Saar, Deutschland
| | - P Mörsdorf
- Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universität des Saarlandes, Kirrberger Straße 1, 66421, Homburg/Saar, Deutschland
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Abstract
Forearm fractures may be complicated by the disruption of the distal radioulnar, proximal radioulnar, or radiocapitellar joints. The key principles in treating this unique subset of fractures include early recognition and management of the injury and restoration and maintenance of the anatomic alignment. This articles addresses radial diaphyseal fractures with distal radioulnar joint disruption, proximal ulnar fractures with radiocapitellar disruption, and disruption of the forearm longitudinal axis and how to properly recognize and manage these forearm fracture-dislocations.
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Affiliation(s)
- Albert V George
- Department of Orthopedic Surgery, University of Michigan Hospital, University of Michigan, 1500 Medical Center Drive, Taubman Center - Orthopedic Surgery Office, Ann Arbor, MI 48109, USA
| | - Jeffrey N Lawton
- Hand and Microsurgery, Department of Orthopedic Surgery, University of Michigan, 2098 South Main Street, Ann Arbor, MI 48103, USA.
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Somford MP, Wiegerinck JI, Hoornenborg D, van den Bekerom MPJ, Eygendaal D. Eponyms in elbow fracture surgery. J Shoulder Elbow Surg 2015; 24:369-75. [PMID: 25595361 DOI: 10.1016/j.jse.2014.10.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2014] [Revised: 10/06/2014] [Accepted: 10/19/2014] [Indexed: 02/01/2023]
Abstract
Eponyms are common in medicine and in orthopaedic surgery. For future reference and historical considerations, we present common eponyms in elbow fracture surgery. We describe in short the biography of the name giver and give, where possible, the original description on which the eponym was based. Whether eponyms should continue to be used is a question that remains unanswered, but if we use them, knowledge of the original description can prevent confusion and knowledge of the historical background sheds light on the interesting roots of our profession.
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Affiliation(s)
- Matthijs P Somford
- Department of Orthopaedic Surgery, Medisch Speectrum Twente, Enschede, The Netherlands.
| | - Johannes I Wiegerinck
- Department of Orthopaedic Surgery, Academic Medical Center, Amsterdam, The Netherlands
| | - Daniël Hoornenborg
- Department of Orthopaedic Surgery, Slotervaart Hospital, Amsterdam, The Netherlands
| | | | - Denise Eygendaal
- Department of Orthopaedic Surgery, Amphia Hospital, Breda, The Netherlands
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Grassmann JP, Hakimi M, Gehrmann SV, Betsch M, Kröpil P, Wild M, Windolf J, Jungbluth P. The treatment of the acute Essex-Lopresti injury. Bone Joint J 2014; 96-B:1385-91. [PMID: 25274926 DOI: 10.1302/0301-620x.96b10.33334] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The Essex-Lopresti injury (ELI) of the forearm is a rare and serious condition which is often overlooked, leading to a poor outcome. The purpose of this retrospective case study was to establish whether early surgery can give good medium-term results. From a group of 295 patients with a fracture of the radial head, 12 patients were diagnosed with ELI on MRI which confirmed injury to the interosseous membrane (IOM) and ligament (IOL). They were treated by reduction and temporary Kirschner (K)-wire stabilisation of the distal radioulnar joint (DRUJ). In addition, eight patients had a radial head replacement, and two a radial head reconstruction. All patients were examined clinically and radiologically 59 months (25 to 90) after surgery when the mean Mayo Modified Wrist Score (MMWS) was 88.4 (78 to 94), the mean Mayo Elbow Performance Scores (MEPS) 86.7 (77 to 95) and the mean disabilities of arm, shoulder and hand (DASH) score 20.5 (16 to 31): all of these indicate a good outcome. In case of a high index of suspicion for ELI in patients with a radial head fracture, we recommend the following: confirmation of IOM and IOL injury with an early MRI scan; early surgery with reduction and temporary K-wire stabilisation of the DRUJ; preservation of the radial head if at all possible or replacement if not, and functional bracing in supination. This will increase the prospect of a good result, and avoid the complications of a missed diagnosis and the difficulties of late treatment.
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Affiliation(s)
- J P Grassmann
- University Hospital Duesseldorf, Department of Trauma and Hand surgery, Moorenstrasse 5, Duesseldorf, 40225, Germany
| | - M Hakimi
- University Hospital Duesseldorf, Department of Trauma and Hand surgery, Moorenstrasse 5, Duesseldorf, 40225, Germany
| | - S V Gehrmann
- University Hospital Duesseldorf, Department of Trauma and Hand surgery, Moorenstrasse 5, Duesseldorf, 40225, Germany
| | - M Betsch
- University Hospital Duesseldorf, Department of Trauma and Hand surgery, Moorenstrasse 5, Duesseldorf, 40225, Germany
| | - P Kröpil
- University Hospital Duesseldorf, Department of Trauma and Hand surgery, Moorenstrasse 5, Duesseldorf, 40225, Germany
| | - M Wild
- University Hospital Duesseldorf, Department of Trauma and Hand surgery, Moorenstrasse 5, Duesseldorf, 40225, Germany
| | - J Windolf
- University Hospital Duesseldorf, Department of Trauma and Hand surgery, Moorenstrasse 5, Duesseldorf, 40225, Germany
| | - P Jungbluth
- University Hospital Duesseldorf, Department of Trauma and Hand surgery, Moorenstrasse 5, Duesseldorf, 40225, Germany
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17
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Duncan SFM, Briski DC, Steinmann SP, Adams J, Kakinoki R. Unique application of a metacarpophalangeal joint implant as a radial head prosthesis. J Shoulder Elbow Surg 2014; 23:e308-e312. [PMID: 25441569 DOI: 10.1016/j.jse.2014.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2014] [Revised: 08/09/2014] [Accepted: 08/13/2014] [Indexed: 02/01/2023]
Affiliation(s)
- Scott F M Duncan
- Department of Orthopedic Surgery, Ochsner Health System, New Orleans, LA, USA.
| | - David C Briski
- Department of Orthopedic Surgery, Ochsner Health System, New Orleans, LA, USA
| | | | - Julie Adams
- Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Ryosuke Kakinoki
- Department of Orthopedic Surgery, Kyoto University, Kyoto, Japan
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18
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Rehim SA, Maynard MA, Sebastin SJ, Chung KC. Monteggia fracture dislocations: a historical review. J Hand Surg Am 2014; 39:1384-94. [PMID: 24792923 PMCID: PMC4266382 DOI: 10.1016/j.jhsa.2014.02.024] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2013] [Revised: 02/18/2014] [Accepted: 02/20/2014] [Indexed: 02/02/2023]
Abstract
The eponym Monteggia fracture dislocation originally referred to a fracture of the shaft of the ulna accompanied by anterior dislocation of the radial head that was described by Giovanni Battista Monteggia of Italy in 1814. Subsequently, a further classification system based on the direction of the radial head dislocation and associated fractures of the radius and ulna was proposed by Jose Luis Bado of Uruguay in 1958. This article investigates the evolution of treatment, classification, and outcomes of the Monteggia injury and sheds light on the lives and contributions of Monteggia and Bado.
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Affiliation(s)
- Shady A Rehim
- Section of Plastic Surgery, Department of Surgery, University of Michigan Health System, Ann Arbor, MI; Department of Hand & Reconstructive Microsurgery, National University Health System, Singapore
| | - Mallory A Maynard
- Section of Plastic Surgery, Department of Surgery, University of Michigan Health System, Ann Arbor, MI; Department of Hand & Reconstructive Microsurgery, National University Health System, Singapore
| | - Sandeep J Sebastin
- Section of Plastic Surgery, Department of Surgery, University of Michigan Health System, Ann Arbor, MI; Department of Hand & Reconstructive Microsurgery, National University Health System, Singapore.
| | - Kevin C Chung
- Section of Plastic Surgery, Department of Surgery, University of Michigan Health System, Ann Arbor, MI; Department of Hand & Reconstructive Microsurgery, National University Health System, Singapore
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19
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Venouziou AI, Papatheodorou LK, Weiser RW, Sotereanos DG. Chronic Essex-Lopresti injuries: an alternative treatment method. J Shoulder Elbow Surg 2014; 23:861-6. [PMID: 24766790 DOI: 10.1016/j.jse.2014.01.043] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Revised: 01/24/2014] [Accepted: 01/27/2014] [Indexed: 02/01/2023]
Abstract
BACKGROUND Currently, no technique has met general acceptance for the restoration of forearm longitudinal stability in chronic Essex-Lopresti injuries. The purpose of this study is to present an alternative treatment method for chronic Essex-Lopresti lesions by radial head replacement and ulnar shortening osteotomy. METHODS Seven patients with a mean age of 42.4 years were included in the study. Five patients had a staged approach, and 2 underwent both procedures simultaneously. The pain level was assessed with the use of a visual analog scale. Elbow, forearm, and wrist range of motion was evaluated. The Mayo Elbow Performance Score and Mayo Wrist Score were used to assess the postoperative outcomes. RESULTS The mean follow-up time was 33 months. The mean pain level was reduced from 8.4 points preoperatively to 3.3 points postoperatively (P < .05). The elbow arc of motion was increased on average from 79° preoperatively to 121° postoperatively (P < .05). Forearm rotation improved from 76° preoperatively to 119° postoperatively (P < .05). The wrist arc of motion improved from 94° preoperatively to 114° postoperatively (P < .05). The mean postoperative Mayo Elbow Performance Score and Mayo Wrist Score were 82 points and 71 points, respectively. The mean ulnar variance was reduced from +8 mm to +3.5 mm postoperatively. CONCLUSION This study shows that radial head replacement in combination with ulnar shortening osteotomy can be used as an alternative reconstructive procedure in the case of a complex chronic Essex-Lopresti injury. This combination of known procedures yields predictable and satisfactory outcomes and a low complication rate. LEVEL OF EVIDENCE Level IV, case series, treatment study.
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Affiliation(s)
- Aaron I Venouziou
- Department of Orthopaedic Surgery, University of Pittsburgh, Orthopaedic Specialists-UPMC, Pittsburgh, PA, USA
| | - Loukia K Papatheodorou
- Department of Orthopaedic Surgery, University of Pittsburgh, Orthopaedic Specialists-UPMC, Pittsburgh, PA, USA
| | - Robert W Weiser
- Department of Orthopaedic Surgery, University of Pittsburgh, Orthopaedic Specialists-UPMC, Pittsburgh, PA, USA
| | - Dean G Sotereanos
- Department of Orthopaedic Surgery, University of Pittsburgh, Orthopaedic Specialists-UPMC, Pittsburgh, PA, USA.
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