19/04/2026
Ortho Case Series #87 |
*Managing a Complex Essex-Lopresti Injury*
High-energy forearm injuries continue to challenge even experienced orthopedic teams, particularly when they involve disruption across multiple anatomical levels.
A 35-year-old male presented following a severe accident with a crush injury to the forearm, later identified as an Montegia Fracture Dislocation with Essex-Lopresti injury.
The injury pattern included:
➡️PRUJ Dislocation with
Comminuted fracture of the ulna Shaft
➡️Disruption of the interosseous membrane
➡️Instability of the distal radioulnar joint (DRUJ) with communited intraarticular displaced fracture of Distal end radius.
Such injuries are often missed initially and, if not managed appropriately, can lead to chronic instability, proximal migration of the radius, and significant functional impairment.
*The surgical management* required:
➡️Careful reconstruction of the radial column + Ulnar Column
➡️Restoration of forearm length and alignment
➡️Addressing PRUJ + DRUJ stability to maintain longitudinal integrity
The real challenge in these cases lies not just in fixation, but in **restoring biomechanics of the entire forearm unit,* hich functions as a single kinetic chain.
Post-operative rehabilitation played an equally critical role, focusing on gradual mobilization while protecting stability.
*Outcome* :
At follow-up, the patient demonstrated excellent functional recovery with restoration of strength and range of motion, highlighting the importance of early recognition and comprehensive management in such complex injury patterns.
