Kapitellum kırığı sonrası kronik longitudinal radioulnar instabilite tedavisinde Sauvé-Kapandji ve ters Sauvé-Kapandji teknikleri

Öz

Essex-Lopresti lezyonlarının nadir görülen bazı atipik formları tanımlanmış olsa da, literatürde bildirilen longitudinal radioulnar instabilite olgularında genellikle radius başı kırığı ve proksimal ve distal radioulnar eklemlerde yaralanma söz konusudur. Bu çalışmada kapitellum kırığı ile birlikte Essex-Lopresti lezyonu olan bir hastayı bildiriyoruz. Olgumuzda el bileğinde Sauvé-Kapandji ve dirsekte ters Sauvé-Kapandji tekniklerinin kombine olarak uygulanması ile orta vadede başarılı sonuçlar alınmıştır. El bileği ve önkol yakınması olmasa bile deplase kapitellum kırıklı hastalarda longitudinal radioulnar instabilite akla getirilmelidir.

Anahtar Kelimeler

• Sauvé-Kapandji tekniği; longitudinal radioulnar instabilite.

Sauvé-Kapandji and reverse Sauvé-Kapandji procedures for treating chronic longitudinal radioulnar dissociation with capitellum fracture

Öz

Almost all reported cases of longitudinal radioulnar dissociation have involved fracture of the radial head, rupture of the interosseous membrane, and disruption of the distal radioulnar joint, although unusual patterns of Essex-Lopresti injury have also been described. To our knowledge, this is the first report of a chronic Essex-Lopresti variant including fracture of the capitellum. A displaced capitellum fracture must alert to the possibility of longitudinal radioulnar dissociation, even without concomitant radial head fracture or symptoms at the forearm and ulnar wrist. Successful mid-term results can be achieved by treating malunion of humeral condyle and proximal migration of the radius with simultaneous Sauvé-Kapandji procedure at the wrist and reverse Sauvé-Kapandji at the elbow.

Anahtar Kelimeler

• Sauvé-Kapandji procedure
• longitudinal radioulnar
• dissociation

Kaynakça

1. Essex-Lopresti P. Fractures of the radial head with distal radio-ulnar dislocation; report of two cases. J Bone Joint Surg Br 1951;33B:244-7.
2. Dodds SD, Yeh PC, Slade JF 3rd. Essex-lopresti injuries. Hand Clin 2008;24:125-37.
3. Rozental TD, Beredjiklian PK, Bozentka DJ. Longitudinal radioulnar dissociation. J Am Acad Orthop Surg 2003;11:68-73.
4. Edwards GS Jr, Jupiter JB. Radial head fractures with acute distal radioulnar dislocation. Essex-Lopresti revisited. Clin Orthop Relat Res 1988;234:61-9.
5. Trousdale RT, Amadio PC, Cooney WP, Morrey BF. Radio-ulnar dissociation. A review of twenty cases. J Bone Joint Surg Am 1992;74:1486-97.
6. Eglseder WA, Hay M. Combined Essex-Lopresti and radial shaft fractures: case report. J Trauma 1993;34:310-2.
7. Gong HS, Chung MS, Oh JH, Lee YH, Kim SH, Baek GH. Failure of the interosseous membrane to heal with immobilization, pinning of the distal radioulnar joint, and bipolar radial head replacement in a case of Essex-Lopresti injury: case report. J Hand Surg Am 2010;35:976-80.
8. Auyeung J, Broome G. The Essex-Lopresti lesion: a variant with a bony distal radioulnar joint injury. J Hand Surg Br 2006;31:206-7.

9. Rodriguez-Martin J, Pretell-Mazzini J, Vidal-Bujanda C. Unusual pattern of Essex-Lopresti injury with negative plain radiographs of the wrist: a case report and literature review. Hand Surg 2010;15:41-5.
10. Duckworth AD, Clement ND, Aitken SA, Ring D, McQueen MM. Essex-Lopresti lesion associated with an impacted radial neck fracture: interest of ulnar shortening in the secondary management of sequelae. J Shoulder Elbow Surg 2011;20:19-24.
11. Sabo MT, Fay K, McDonald CP, Ferreira LM, Johnson JA, King GJ. Effect of coronal shear fractures of the distal humerus on elbow kinematics and stability. J Shoulder Elbow Surg 2010;19:670-80.
12. Jungbluth P, Frangen TM, Arens S, Muhr G, Kälicke T. The undiagnosed Essex-Lopresti injury. J Bone Joint Surg Br 2006;88:1629-33.
13. Karlstad R, Morrey BF, Cooney WP. Failure of freshfrozen radial head allografts in the treatment of EssexLopresti injury. A report of four cases. J Bone Joint Surg Am 2005;87:1828-33.
14. Szabo RM, Hotchkiss RN, Slater RR Jr. The use of frozen-allograft radial head replacement for treatment of established symptomatic proximal translation of the radius: preliminary experience in five cases. J Hand Surg Am 1997;22:269-78.
15. Heijink A, Morrey BF, van Riet RP, O’Driscoll SW, Cooney WP 3rd. Delayed treatment of elbow pain and dysfunction following Essex-Lopresti injury with metallic radial head replacement: a case series. J Shoulder Elbow Surg 2010;19:929-36.
16. Sowa DT, Hotchkiss RN, Weiland AJ. Symptomatic proximal translation of the radius following radial head resection. Clin Orthop Relat Res 1995;317:106-13.
17. Marcotte AL, Osterman AL. Longitudinal radioulnar dissociation: identification and treatment of acute and chronic injuries. Hand Clin 2007;23:195-208.
18. Adams JE, Steinmann SP, Osterman AL. Management of injuries to the interosseous membrane. Hand Clin 2010;26:543-8.
19. Adams JE, Culp RW, Osterman AL. Interosseous membrane reconstruction for the Essex-Lopresti injury. J Hand Surg Am 2010;35:129-36.
20. Peterson CA 2nd, Maki S, Wood MB. Clinical results of the one-bone forearm. J Hand Surg Am 1995;20:609-18.
21. Kamineni S, Maritz NG, Morrey BF. Proximal radial resection for posttraumatic radioulnar synostosis: a new technique to improve forearm rotation. J Bone Joint Surg Am 2002;84-A:745-51.
22. Ikeda M, Oka Y. Function after early radial head resection for fracture: a retrospective evaluation of 15 patients followed for 3-18 years. Acta Orthop Scand 2000;71:191-4.