Essex-Lopresti Longitudinal Instability of the Forearm

Essex Lopresti Lesion: Does it exist?

Adam C Watts Consultant Elbow and Upper Limb Surgeon, Wrightington

Hospital

Visiting Professor, University of Manchester

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www.wrightington.com2


www.wrightington.com

Peter Essex-Lopresti

Born 1916 Trained at Royal London Hospital Joined RAMC in WWII Huntarian Professor 1951 Os calcis fracture classification Died suddenly aged 35

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Longitudinal - Essex-Lopresti




“Hidden Injury” - IOM

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Load transfer

Prevent radius and ulna bowing

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Role of IOM



How common is this lesion?

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Tightrope Reconstruction

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Bone-ligament-bone graft

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Ligament Augmentation and Reconstruction System (LARS)

Polyester rope

Ultimate stress 2600N

Residual Strain at 2500N = 1.5%

Stiffness = 209N/mm (cf 129 native IOM)

No damage after 5 million cycles

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Experience to date

12 Procedures (chronic injuries) min follow-up 18

months

1 persistent axial instability - revised to OBF

No other recurrent proximal migration

Mean DASH improved 77 to 41/100

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Rare lesion after high energy axial load

Need to address soft tissue injury

Prognosis is generally poor

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Longitudinal Forearm Instability

Health & Medicine

Essex-Lopresti Longitudinal Instability of the Forearm