Essex-Lopresti fracture


An Essex-Lopresti injury consists of the classic triad radial head fracture with dislocation of the distal radioulnar joint (DRUJ) and disruption of the interosseous membrane (IOM)

Current surgical treatment of this injury consists of open reduction internal fixation or replacement of the radial head and stabilization of the DRUJ.

1930 – Brockman two cases of disability at the wrist-joint following excision of the head of the radius. [1931; 24(7): 904–905]

Essex-Lopresti fracture Wrist Brockman 1931
Subluxation of inferior radio-ulnar joint following excision of head of radius. Brockman 1931

1946 – Curr and Coe reported the first documented case of an Essex-Lopresti injury. The patient suffered a radial head fracture and concomitant dislocation of the DRUJ in a mining accident. His arm was caught between two mining hutches causing swelling and limited movement at the elbow, forearm, and wrist. The hand was radially deviated, and the DRUJ was dislocated. The patient complained of severe pain and had gross swelling of the whole forearm, which they ascribed to tearing of the interosseous membrane. [Br J Surg. 1946]

Treated with traction, closed reduction and immobilisation. Resulted in good elbow and wrist movement but pronation and supination limited to 5 degrees.

Curr and Coe the first Essex-Lopresti injury 1946
Fig 100. A B, Vertical and posterior dislocation of inferior radio-ulnar joint. D, Fracture of head of radius and dislocation. Curr and Coe 1946

1951Peter Essex-Lopresti (1916-1951) reported two cases. He noted that:

  • this was a rare injury but suggested that DRUJ integrity must be inspected when a radial head fracture is present;
  • that radial head fracture and DRUJ dislocation were associated with IOM disruption;
  • excision of the radial head should be avoided and ORIF should be employed
  • in cases with severe comminution, a prosthesis could be used to replace the radial head
Essex-Lopresti fracture 1951
Comminuted fracture of radial head with proximal displacement of radial shaft. Dislocation of DRUJ with radial deviation at wrist. Essex-Lopresti 1951

1999Failla uses ultrasound to effectively diagnose and locate torn interosseous membranes in forearm fracture/dislocations.

Associated Persons


Original Articles

Review articles


the names behind the name

Dr Eleanor Boden LITFL Author

MBChB (University of Bristol), BSc (Durham University). Emergency medicine RMO at Sir Charles Gairdner hospital. Swimmer, interested in all things sports medicine.

BA MA (Oxon) MBChB (Edin) FACEM FFSEM. Emergency physician, Sir Charles Gairdner Hospital.  Passion for rugby; medical history; medical education; and asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books | Twitter |

Leave a Reply

This site uses Akismet to reduce spam. Learn how your comment data is processed.