Interosseous Membrane Reconstruction with Suture Button for Essex-Lopresti Fracture and Lateral Collateral Ligament Complex Rupture Leading to Rerupture of the Ligament and Radial Head Dislocation

An Essex-Lopresti fracture is a relatively rare traumatic injury. Loss of bony support because of fracture of the radial head, dislocation of the distal radioulnar (DRU) joint, and a simultaneous rupture of the interosseous membrane (IOM) result in proximal migration of the radius, making treatment exceedingly challenging. In treating an acute Essex-Lopresti fracture, reconstruction of the radial length and stabilization of the DRU joint are essential. However, the indications for acute IOM reconstruction and the prognosis are unclear. This report describes an acute Essex-Lopresti fracture complicated by lateral collateral ligament complex and terrible triad injury in which IOM reconstruction was performed using a suture button. After surgery, tension from the suture button led to lateral collateral ligament rerupture and posterior dislocation of the radial head. Temporary fixation of the radius and ulna may be necessary to prevent that complication with IOM reconstruction for acute Essex-Lopresti fractures with an lateral collateral ligament complex rupture.