The Essex-Lopresti fracture-dislocation factors in early management and salvage alternatives.

Treatment recommendations for the Essex-Lopresti lesion have not come very far in 50 years. Although there have been multiple biomechanical studies, the biomechanics of forearm loading and stability remain somewhat elusive. Clinical studies have yielded some insight, but predictable outcomes are exceptional. More studies are needed to further understand the biomechanics of the forearm and provide a basis for reconstruction of the IOL. Although current clinical studies regarding IOL reconstruction and radial head replacement seem promising, long-term results with substantial patient numbers are needed. In the short term, the Essex-Lopresti lesion continues to challenge clinicians.