Journal of shoulder and elbow surgery · 2026
Acute Versus Chronic Essex-Lopresti Injuries: A Systematic Review of Management Strategies and Outcome Patterns.
СтатьяОбзорНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Khan Wahaj, O'Neill Alexander, Senthil Aakash, Haque Omar, Bouchard Marc Daniel, Nijjar Manraj, Vivekanantha Prushoth, Yan James
Аннотация
BACKGROUND: Essex-Lopresti injury is a rare but severe forearm injury involving radial head fracture, interosseous membrane disruption, and distal radioulnar joint instability, with management and outcomes varying by injury chronicity. The purpose of this systematic review was to highlight and evaluate the outcomes of different operative treatments for acute versus chronic Essex-Lopresti injury (ELI).
METHODS: A comprehensive search of OVID MEDLINE, Embase, and Emcare databases was conducted in October 2025. Eligible studies were primary research articles including randomized controlled trials, cohort studies, observational studies, and case series, published after 2000 reporting operative management of ELIs with ≥ 5 patients. Two independent reviewers screened studies and extracted data. Cohorts were categorized as acute or chronic ELI, where, acute ELI was defined as <4 weeks from injury to surgery and chronic ELI as >4 weeks. Due to heterogeneity and small sample sizes, findings were synthesized narratively. Descriptive statistics summarized outcomes with pooled mean utilized where appropriate.
RESULTS: Eleven studies met inclusion criteria, four acute and nine chronic cohorts, totaling 163 patients (52 acute, 111 chronic). Surgical approaches differed between cohorts, with acute management often prioritizing early restoration of forearm stability and chronic management more frequently required reconstruction or revision procedures. The pooled estimates and ranges of common patient-reported outcome measures for acute ELI relative to chronic ELI included: Mayo Elbow Performance Score (82.0-92.0 vs 71.0-85.8), Mayo Wrist Score (81.3-90.8 vs 61.3-82.7), and Disability of the Arm, Shoulder and Hand score (12.5-20.5 vs 24.0-55.0). Chronic ELI was associated with higher rates of complications (25.3% vs 12.1%), most commonly instability or nerve injury, and reoperations (43.5% vs 25.0%), relative to acute ELI.
CONCLUSIONS: Available evidence suggests variable, often suboptimal outcomes for different management strategies of both acute and chronic ELI, with notable rates of complications and reoperations. Outcomes appeared modestly better in acute cohorts than in chronic cohorts, underscoring the importance of early recognition and treatment. However, comparative evidence across surgical interventions remains low, precluding any definitive recommendation regarding an optimal treatment strategy. Significant heterogeneity across studies further limited direct comparisons, highlighting the need for higher-quality prospective studies to better characterize outcomes and techniques used to treat both acute and chronic ELI.
METHODS: A comprehensive search of OVID MEDLINE, Embase, and Emcare databases was conducted in October 2025. Eligible studies were primary research articles including randomized controlled trials, cohort studies, observational studies, and case series, published after 2000 reporting operative management of ELIs with ≥ 5 patients. Two independent reviewers screened studies and extracted data. Cohorts were categorized as acute or chronic ELI, where, acute ELI was defined as <4 weeks from injury to surgery and chronic ELI as >4 weeks. Due to heterogeneity and small sample sizes, findings were synthesized narratively. Descriptive statistics summarized outcomes with pooled mean utilized where appropriate.
RESULTS: Eleven studies met inclusion criteria, four acute and nine chronic cohorts, totaling 163 patients (52 acute, 111 chronic). Surgical approaches differed between cohorts, with acute management often prioritizing early restoration of forearm stability and chronic management more frequently required reconstruction or revision procedures. The pooled estimates and ranges of common patient-reported outcome measures for acute ELI relative to chronic ELI included: Mayo Elbow Performance Score (82.0-92.0 vs 71.0-85.8), Mayo Wrist Score (81.3-90.8 vs 61.3-82.7), and Disability of the Arm, Shoulder and Hand score (12.5-20.5 vs 24.0-55.0). Chronic ELI was associated with higher rates of complications (25.3% vs 12.1%), most commonly instability or nerve injury, and reoperations (43.5% vs 25.0%), relative to acute ELI.
CONCLUSIONS: Available evidence suggests variable, often suboptimal outcomes for different management strategies of both acute and chronic ELI, with notable rates of complications and reoperations. Outcomes appeared modestly better in acute cohorts than in chronic cohorts, underscoring the importance of early recognition and treatment. However, comparative evidence across surgical interventions remains low, precluding any definitive recommendation regarding an optimal treatment strategy. Significant heterogeneity across studies further limited direct comparisons, highlighting the need for higher-quality prospective studies to better characterize outcomes and techniques used to treat both acute and chronic ELI.