The Essex-Lopresti fracture consists of a comminuted and displaced radial head fracture along with disruption of the distal radioulnar joint and interosseous membrane. The thickened ridge of the scaphoid and lunate facets dissipates the energy delivered to the wrist in a FOOSH injury and is thought to account for fractures that occur between the scaphoid and lunate facets of the radius. The fracture line originates at the junction of the scaphoid and lunate fossae on the radial articular surface and courses laterally in a transverse or oblique direction. The intra-articular distal radial fracture of the radial styloid is associated with an avulsion of the radial collateral ligament.
Routine PA and true lateral views are obtained. On the PA view, overlap, widening, or incongruity of the radioulnar joint should be noted. Resnick notes that careful radiographic positioning and measurements are essential, as is transaxial CT scanning or MRI, to assess the extent of displacement or subluxation of the radioulnar joint.
Complications are similar to those of a Colles fractures and include radioulnar joint instability and TFC damage.
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