Elbow Dislocation With Associated Essex-Lopresti Injury: A Case Treated Conservatively

Abstract

A 23-year-old woman suffered a posterior elbow dislocation, distal radius intraarticular fracture, distal radioulnar joint subluxation, and coronoid process fracture, suggesting an Essex-Lopresti injury variant. Closed reduction for the elbow dislocation was performed, and the limb was immobilized at a 90-degree angle with the forearm in a neutral position with a long posterior splint. Three months later complete fracture healing was noted radiologically. One year post-injury full range of motion regarding flexion, pronation, and supination was achieved with only 10 degrees of extension deficit remaining, suggesting a case of Essex-Lopresti injury managed conservatively with excellent results.

Keywords: eli; ell; essex; essex-lopresti; forearm instability; interosseus membrane; iom; lopresti.

Figure 1. Anteroposterior, (a) lateral elbow, (b) anteroposterior wrist, (c) X-rays at time of injury. Posterior elbow dislocation along with DRUJ dislocation are evident.

DRUJ: distal radio-ulnar joint

Figure 2. Anteroposterior (a) and lateral elbow (b) and anteroposterior (c) and lateral wrist (d) x-rays after reduction. The coronoid process fracture (type 2) and the intraarticular distal radius fracture are evident. No positive ulnar variance is noted.

Figure 3. Three months post-injury anteroposterior (a) and lateral elbow (b) x-rays. Complete fracture healing noted on the coronoid process fracture.