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<p>A&#xa0;67-year-old man with a&#xa0;chronic Essex–Lopresti injury was initially misdiagnosed owing to a&#xa0;mild clinical presentation and bilateral positive ulnar variance, which obscured radiographic assessment of proximal radial migration. To restore forearm stability, radial head arthroplasty, central band reconstruction with a&#xa0;pronator teres autograft, and ulnar shortening osteotomy were performed. This case underscores the importance of early clinical suspicion and comprehensive bilateral imaging for the accurate diagnosis of Essex-Lopresti injuries. Reconstruction of the interosseous membrane, particularly the central band, combined with radial head arthroplasty and, when indicated, ulnar shortening osteotomy can result in favorable functional outcomes even in chronic cases.</p>

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Missed Essex–Lopresti lesion in the presence of bilateral positive ulnar variance

  • 期刊论文

  • 发表日期：

    2025年10月10日

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  • Muriel Sauvant,
  • Christian K. Spies

摘要

A 67-year-old man with a chronic Essex–Lopresti injury was initially misdiagnosed owing to a mild clinical presentation and bilateral positive ulnar variance, which obscured radiographic assessment of proximal radial migration. To restore forearm stability, radial head arthroplasty, central band reconstruction with a pronator teres autograft, and ulnar shortening osteotomy were performed. This case underscores the importance of early clinical suspicion and comprehensive bilateral imaging for the accurate diagnosis of Essex-Lopresti injuries. Reconstruction of the interosseous membrane, particularly the central band, combined with radial head arthroplasty and, when indicated, ulnar shortening osteotomy can result in favorable functional outcomes even in chronic cases.