Anatomic Interosseus Membrane Reconstruction Utilizing the Biceps Button and Screw Tenodesis for Essex-Lopresti Injuries

Miller, A.; Naik, Tejal U.; Seigerman, Daniel; Ilyas, Asif M.

doi:10.1097/bth.0000000000000107

Cited by 20 publications

(23 citation statements)

References 24 publications

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“…Due to donor site morbidity of autografts and concerns regarding the long-term outcomes of synthetic devices, various allografts have emerged as alternative reconstruction options. 3,12,39 Some authors treated a patient 32 months after his Essex-Lopresti injury using a BPB allograft in order to avoid donor site morbidity. 3 They reported excellent clinical and radiological results and suggested the use of an allograft as an alternative.…”

Section: Surgical Techniques: Clinical Studiesmentioning

confidence: 99%

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Essex-Lopresti injuries: an update

et al. 2019

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Reconstruction of the central band of the interosseous membrane is an emerging procedure implemented in the treatment of longitudinal radioulnar dissociation (LRUD), usually in its chronic setting, after Essex-Lopresti injuries of the forearm. There are no sufficient clinical data to support reconstruction of the central band of the interosseous membrane in acute LRUD injuries. Clinical and cadaveric studies comparing autografts (palmaris longus, flexor carpi radialis and bone-patellar-bone), allografts (Achilles tendon) and synthetic ligaments have not shown superiority of one technique versus another; however, they have shown special concerns with respect to the use of synthetic grafts. Latrogenic fracture, decrease of rotational range of movement, iatrogenic nerve injury (superficial radial and median nerve), donor site morbidity with autografts and recurrent instability are the complications reported in literature after interosseous membrane reconstruction. Cite this article: EFORT Open Rev 2019;4:143-150. DOI: 10.1302/2058-5241.4.180072

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Section: Surgical Techniques: Clinical Studiesmentioning

confidence: 99%

“…Regarding the technique, both autografts and synthetic ligaments have been used in various techniques; although numerous experimental cadaveric studies have been performed, there is a relative scarcity of clinical data. 7–12…”

Section: Introductionmentioning

confidence: 99%

Essex-Lopresti injuries: an update

et al. 2019

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“…Donor age, and post mortem conditions and interval were further limitations of the study. Many techniques have been described for the reconstruction of the CB in chronic Essex-Lopresti injuries, including: bone-patellar tendon-bone graft (Gaspar et al 2018); synthetic grafts (Sabo & Watts, 2012); tightrope tenodesis (Brin et al 2014); tendons grafts, such as the anterior tibial (Miller et al 2016), palmaris longus (Tejwani et al 2005), flexor carpi radialis (Skahen et al 1997), semitendinosus (Soubeyrand et al 2006), Achilles tendon (Stabile et al 2005), fascia lata (Bigazzi et al 2017), and pronator teres rerouting (Chloros et al 2008). Based on the present study, the CB is sparsely innervated, which accords with its static stability functions (Werner et al 2011;Anderson et al 2015), and reconstruction could be performed with non-sensory tissue (Skahen et al 1997;Tejwani et al 2005;Soubeyrand et al 2006;Miller et al 2016) or material (Sabo & Watts, 2012;Brin et al 2014) from the proprioceptive point of view.…”

Section: Figmentioning

confidence: 99%

“…The IOM plays an important role in this synergy. The role of proprioception in dynamic neuromuscular control of the forearm stability is important, therefore, for the treatment of forearm injuries involving bone, ligaments and joint capsules (Essex-Lopresti, 1951;Sabo & Watts, 2012;Grassmann et al 2014;Miller et al, 2016;Gaspar et al 2018).…”

Section: Introductionmentioning

confidence: 99%

Immunofluorescence analysis of sensory nerve endings in the interosseous membrane of the forearm

et al. 2019

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The human interosseous membrane (IOM) is a fundamental stabilizer during forearm rotation. To investigate the dynamic aspects of forearm stability, we analyzed sensory nerve endings in the IOM. The distal oblique bundle (DOB), the distal accessory band (DAB), the central band (CB), the proximal accessory band (PAB), the dorsal oblique accessory cord (DOAC) and the proximal oblique cord (POC) were dissected from 11 human cadaver forearms. Sensory nerve endings were analyzed at two levels per specimen as total cell amount/mm 2 after immunofluorescence staining with low-affinity neurotrophin receptor p75, protein gene product 9.5, S-100 protein and 4 0 , 6-diamidino-2-phenylindole on an Apotome microscope, according to Freeman and Wyke's classification. Sensory nerve endings were significantly more commonly found to be equally distributed throughout the structures, rather than being epifascicular, interstitial, or close to the insertion into bone (P ≤ 0.001, respectively). Free nerve endings were the predominant mechanoreceptor in all six structures, with highest density in the DOB, followed by the POC (P ≤ 0.0001, respectively). The DOB had the highest density of Pacini corpuscles. The DOAC and CB had the lowest amounts of sensory innervation. The high density of sensory corpuscles in the DOB, PAB and POC indicate that proprioceptive control of the compressive and directional muscular forces acting on the distal and proximal radioulnar joints is monitored by the DOB, PAB and POC, respectively, due to their closed proximity to both joints, whereas the central parts of the IOM act as structures of passive restraint.

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“…Numerous techniques have been described for reconstruction of the IOM, including direct repair when possible, 8,40 synthetic graft, 33,41 TightRope tenodesis, 42 anatomic allograft, 43 bone patella tendon bone autograft and allograft, 25 flexor carpi radialis autograft, 28 semitendinosus autograft, 44 Achilles allograft, 27,45 and pronator rerouting. 46 Several comparative studies have been done to assess the biomechanical results of select IOM reconstructive techniques.…”

Section: Iom Reconstructive Techniquesmentioning

confidence: 99%

Management of the Essex-Lopresti Injury

Matson

Ruch

2016

Jnl Wrist Surg

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Essex-Lopresti injuries (ELIs) are characterized by fracture of the radial head, disruption of the forearm interosseous membrane, and dislocation of the distal radioulnar joint. This injury pattern results in axial and longitudinal instability of the forearm. Initial radiographs may fail to reveal the full extent of the injury, and therefore diagnosis in the acute setting requires a high index of suspicion. Early recognition and treatment are preferred as failure to fully treat the problem may result in chronic wrist pain from ulnar abutment or chronic elbow pain from radiocapitellar arthrosis. In this article the presentation, relevant anatomy, and management options for ELIs are overviewed, and a summary of outcomes reported in the literature is provided. Additionally, the preferred surgical technique of the senior author is presented, which involves reconstruction of the interosseous membrane with a local pronator rerouting autograft.

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Anatomic Interosseus Membrane Reconstruction Utilizing the Biceps Button and Screw Tenodesis for Essex-Lopresti Injuries

Cited by 20 publications

References 24 publications

Essex-Lopresti injuries: an update

Essex-Lopresti injuries: an update

Immunofluorescence analysis of sensory nerve endings in the interosseous membrane of the forearm

Management of the Essex-Lopresti Injury

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