Abstract
A 67-year-old male sustained a fracture and dislocation of the right radial head with ipsilateral distal radioulnar dislocation in a traffic accident. Six days after immediate reduction and immobilization with a long arm plaster splint, open reduction of the fracture was performed and fixed with Herbert screws, supplemented by proximal and distal radioulnar transfixations with two K-wires in supination and long arm casting. Four weeks after surgery, the K-wires were removed and an active ROM exercise was started. Six months after surgery, he showed 135°of flexion, -12°of extension, and a full range of supination and pronation without pain.
Fracture, or fracture and dislocation of the radial head accompanied by distal radioulnar dislocation, which is quite rare, has been called Essex-Lopresti fracture since he reported two cases in 1951, following the earliest report made by Curr and Coe in 1946. Only 18 cases have been reported. All the cases in which the distal radioulnar dislocation had been overlooked or the radial head had been resected showed poor results. In any cases of radial head fracture, careful attention should be paid to the distal radioulnar joint. For treatment, restoration of the radial length by either open reduction and internal fixation or prosthetic replacement is extremely important. Resection of the radial head should never be done.
