View source for Essex-Lopresti fracture

==Background==
*Triad of [[radial head fracture]], disruption of interosseous membrane, and [[distal radioulnar joint disruption]]

==Clinical Features==
*Unstable and painful forearm
*Axial force from wrist to elbow after fall on outstretched hand
*Grip weakness and difficulty pronating wrist

==Differential Diagnosis==
{{Elbow DDX}}

==Evaluation==
[[File:PMC3967261 ORT-85-177-g001.png|thumb|Essex-Lopresti fracture with radial head fracture (left) and dorsal subluxation of the ulna (right).]]
===Workup===
*PA and lateral radiography of the elbow and forearm (may only show a [[radial head fracture]])

===Diagnosis===
*The injury can be difficult to diagnose initially, as the attention is focused on the injury to the radial head, leading to the distal radio-ulnar injury being overlooked. 
*The examination finding of tenderness of the distal radio-ulnar joint suggests an Essex-Lopresti injury in patients who have sustained high energy forearm trauma. 
*Plain radiography shows the radial head fracture, with dorsal subluxation of the ulna often seen on lateral view of the pronated wrist
*Radial pull test: >3mm displacement dorsal/volar is consistent with Essex-Lopresti
*May require CT to evaluate subtle fractures

==Management==
*Orthopedic referral

==Disposition==
*Per ortho - usually outpatient operative management (radial head arthroplasty)

==See Also==
*[[Radial head fracture]]

==External Links==

==References==
<references/>
*Williams D. Wrist and forearm. In: Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2014.
*https://www.orthobullets.com/trauma/1019/radial-head-fractures
[[Category:Orthopedics]] [[Category:Trauma]]