A 40-year-old man falls from a height. X-ray shows a comminuted fracture of the radial head. On examination there is tenderness and instability at the wrist, and widening of the distal radioulnar joint. Which additional structure must be assumed injured for this combination to be complete?

• A The triangular fibrocartilage complex alone
• B The flexor digitorum profundus origin
• C The annular ligament
• D The interosseous membrane of the forearm ✓

Explanation

Essex-Lopresti injury is a triad of comminuted radial head fracture, rupture of the interosseous membrane, and disruption of the distal radioulnar joint, producing axial instability of the forearm. Longitudinal load travels from the wrist through the interosseous membrane to the radial head. Recognising the membrane rupture matters because excision of the radial head without prosthetic replacement allows proximal migration of the radius and chronic wrist pain. The TFCC may be involved but the defining third element is the membrane.

Reference: Rockwood and Green's Fractures in Adults, 9th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.