Bertrand Coulet, Hugo Barret, Pierre Emmanuel Chammas, Olivier Bozon, Lara Moscato, Cyril Lazerges, Michel Chammas
{"title":"前臂纵向不稳定(埃塞克斯-洛普雷斯蒂综合征)的病理生理学及对治疗的影响。","authors":"Bertrand Coulet, Hugo Barret, Pierre Emmanuel Chammas, Olivier Bozon, Lara Moscato, Cyril Lazerges, Michel Chammas","doi":"10.1016/j.hansur.2024.101968","DOIUrl":null,"url":null,"abstract":"<div><div>Longitudinal forearm instability, or Essex-Lopresti syndrome, associates radial head fracture and rupture of the structures uniting the 2 bones, mainly the interosseous membrane and triangular fibrocartilage complex adjacent to the distal radioulnar joint.</div><div>It is often overlooked at first, and should be screened for in case of comminuted radial head fracture without elbow dislocation or instability.</div><div>Treatment should be prompt, within 4 weeks of trauma, to avoid soft-tissue retraction and hopefully allow healing. This interval is anecdotal, without firm evidence, but matches observations regularly reported in the literature <span><span>[1]</span></span>.</div><div>In the acute phase, treatment consists in rigid, usually unipolar, radial head replacement, protected healing of the interosseous membrane by a TightRope suture button between the bones, radioulnar pinning and triangular fibrocartilage complex suture, followed by 6 weeks’ immobilization. Progression is usually favorable.</div><div>Chronic forms, beyond 4 weeks, when soft-tissue healing is impossible, require interosseous membrane reconstruction. In case of radiocarpal impingement due to ascension of the radius, ulnar shortening osteotomy must be associated. Medium-term results in such cases are much less certain.</div><div>As a last resort, the “one-bone forearm” is a solution.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"43 6","pages":"Article 101968"},"PeriodicalIF":0.9000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Pathophysiology of longitudinal forearm instability (Essex-Lopresti syndrome) and implications for treatment\",\"authors\":\"Bertrand Coulet, Hugo Barret, Pierre Emmanuel Chammas, Olivier Bozon, Lara Moscato, Cyril Lazerges, Michel Chammas\",\"doi\":\"10.1016/j.hansur.2024.101968\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><div>Longitudinal forearm instability, or Essex-Lopresti syndrome, associates radial head fracture and rupture of the structures uniting the 2 bones, mainly the interosseous membrane and triangular fibrocartilage complex adjacent to the distal radioulnar joint.</div><div>It is often overlooked at first, and should be screened for in case of comminuted radial head fracture without elbow dislocation or instability.</div><div>Treatment should be prompt, within 4 weeks of trauma, to avoid soft-tissue retraction and hopefully allow healing. This interval is anecdotal, without firm evidence, but matches observations regularly reported in the literature <span><span>[1]</span></span>.</div><div>In the acute phase, treatment consists in rigid, usually unipolar, radial head replacement, protected healing of the interosseous membrane by a TightRope suture button between the bones, radioulnar pinning and triangular fibrocartilage complex suture, followed by 6 weeks’ immobilization. Progression is usually favorable.</div><div>Chronic forms, beyond 4 weeks, when soft-tissue healing is impossible, require interosseous membrane reconstruction. In case of radiocarpal impingement due to ascension of the radius, ulnar shortening osteotomy must be associated. Medium-term results in such cases are much less certain.</div><div>As a last resort, the “one-bone forearm” is a solution.</div></div>\",\"PeriodicalId\":54301,\"journal\":{\"name\":\"Hand Surgery & Rehabilitation\",\"volume\":\"43 6\",\"pages\":\"Article 101968\"},\"PeriodicalIF\":0.9000,\"publicationDate\":\"2024-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Hand Surgery & Rehabilitation\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2468122924003992\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Hand Surgery & Rehabilitation","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2468122924003992","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Pathophysiology of longitudinal forearm instability (Essex-Lopresti syndrome) and implications for treatment
Longitudinal forearm instability, or Essex-Lopresti syndrome, associates radial head fracture and rupture of the structures uniting the 2 bones, mainly the interosseous membrane and triangular fibrocartilage complex adjacent to the distal radioulnar joint.
It is often overlooked at first, and should be screened for in case of comminuted radial head fracture without elbow dislocation or instability.
Treatment should be prompt, within 4 weeks of trauma, to avoid soft-tissue retraction and hopefully allow healing. This interval is anecdotal, without firm evidence, but matches observations regularly reported in the literature [1].
In the acute phase, treatment consists in rigid, usually unipolar, radial head replacement, protected healing of the interosseous membrane by a TightRope suture button between the bones, radioulnar pinning and triangular fibrocartilage complex suture, followed by 6 weeks’ immobilization. Progression is usually favorable.
Chronic forms, beyond 4 weeks, when soft-tissue healing is impossible, require interosseous membrane reconstruction. In case of radiocarpal impingement due to ascension of the radius, ulnar shortening osteotomy must be associated. Medium-term results in such cases are much less certain.
As a last resort, the “one-bone forearm” is a solution.
期刊介绍:
As the official publication of the French, Belgian and Swiss Societies for Surgery of the Hand, as well as of the French Society of Rehabilitation of the Hand & Upper Limb, ''Hand Surgery and Rehabilitation'' - formerly named "Chirurgie de la Main" - publishes original articles, literature reviews, technical notes, and clinical cases. It is indexed in the main international databases (including Medline). Initially a platform for French-speaking hand surgeons, the journal will now publish its articles in English to disseminate its author''s scientific findings more widely. The journal also includes a biannual supplement in French, the monograph of the French Society for Surgery of the Hand, where comprehensive reviews in the fields of hand, peripheral nerve and upper limb surgery are presented.
Organe officiel de la Société française de chirurgie de la main, de la Société française de Rééducation de la main (SFRM-GEMMSOR), de la Société suisse de chirurgie de la main et du Belgian Hand Group, indexée dans les grandes bases de données internationales (Medline, Embase, Pascal, Scopus), Hand Surgery and Rehabilitation - anciennement titrée Chirurgie de la main - publie des articles originaux, des revues de la littérature, des notes techniques, des cas clinique. Initialement plateforme d''expression francophone de la spécialité, la revue s''oriente désormais vers l''anglais pour devenir une référence scientifique et de formation de la spécialité en France et en Europe. Avec 6 publications en anglais par an, la revue comprend également un supplément biannuel, la monographie du GEM, où sont présentées en français, des mises au point complètes dans les domaines de la chirurgie de la main, des nerfs périphériques et du membre supérieur.