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Fractures: Bone Repair

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Interosseus Membrane Reconstruction Following a Forearm Injury: A Case Report.

S J Shine¹, H B Bamberger², C E Spieser³

¹Fourth Year Orthopedic Surgery Resident, Department of Orthopedic Surgery, Kettering Health Network, Grandview Medical Center, Dayton, Ohio.

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Summary

This summary is machine-generated.

Repairing the interosseous membrane (IOM) central band in Essex-Lopresti injuries restores elbow and distal radioulnar joint stability. This surgical approach improves forearm function and addresses complex forearm/elbow trauma.

Keywords:

DRUJ injury Essex-Lopresti injury forearm injury interosseous membrane radiocapitellar joint

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Area of Science:

Orthopedic Surgery
Trauma Management
Biomechanics

Background:

Essex-Lopresti injuries involve radial head fractures with distal radioulnar joint (DRUJ) and interosseous membrane (IOM) disruption.
Management of IOM involvement is controversial due to underdiagnosis and unclear functional significance.
Optimal treatment strategies for these complex injuries require further elucidation.

Observation:

A patient with an open radial shaft fracture experienced elbow instability and near-complete IOM disruption.
Persistent rotational instability was noted after radius fixation.
Surgical reconstruction of the IOM central band using suture and button was performed.

Findings:

IOM central band reconstruction restored longitudinal and rotational stability to the radiocapitellar joint and DRUJ.
The patient achieved stable elbow and DRUJ function one year post-surgery, returning to labor.
Biomechanical studies support the central band's critical role in rotational elbow stability.

Implications:

Acute IOM central band repair can significantly improve outcomes for Essex-Lopresti injuries.
This case highlights the potential of IOM repair in restoring forearm stability and elbow function.
Further research is warranted to validate IOM repair as a standard treatment for these complex fractures.