TY - JOUR
T1 - Radial axial interosseous load (RAIL) test for essex lopresti type injuries
AU - Lum, Zachary C.
AU - Huish, Eric G.
AU - Trzeciak, Marc A.
N1 - Publisher Copyright:
© 2018 Prof. PK Surendran Memorial Education Foundation
PY - 2018/3
Y1 - 2018/3
N2 - Background: When approaching radial head and neck fractures, the decision for ORIF, resection, or arthroplasty is often performed intraoperatively. Factors that contribute include ligamentous and bony stability, cartilage injury, mechanical alignment as well as patient factors. Recent data has suggested conventional methods may not be sufficiently sensitive in detecting Essex Lopresti injuries. Here we describe an intraoperative technique that could objectively assess proximal radio-ulnar stability with subsequent disruption of the ligamentous structures. Methods: Eight cadaveric specimens were used to evaluate amount of radial proximal migration between three groups of forearms. After radial head resection, proximal migration of the radial shaft was measured in three distinct groups. Group A included intact forearms, Group B included forearms with resected interosseous membranes (IOM), and Group C included forearms with resected interosseous membranes and distal radioulnar joint (DRUJ) disruptions. Results: As compared to group A, group B averaged 4 mm of proximal radial migration (p < 0.01), while Group C demonstrated >6 mm of migration (p < 0.01). Conclusion: In the setting of a non-repairable radial head, the RAIL test may provide a more objective means of assessing for Essex-Lopresti injuries.
AB - Background: When approaching radial head and neck fractures, the decision for ORIF, resection, or arthroplasty is often performed intraoperatively. Factors that contribute include ligamentous and bony stability, cartilage injury, mechanical alignment as well as patient factors. Recent data has suggested conventional methods may not be sufficiently sensitive in detecting Essex Lopresti injuries. Here we describe an intraoperative technique that could objectively assess proximal radio-ulnar stability with subsequent disruption of the ligamentous structures. Methods: Eight cadaveric specimens were used to evaluate amount of radial proximal migration between three groups of forearms. After radial head resection, proximal migration of the radial shaft was measured in three distinct groups. Group A included intact forearms, Group B included forearms with resected interosseous membranes (IOM), and Group C included forearms with resected interosseous membranes and distal radioulnar joint (DRUJ) disruptions. Results: As compared to group A, group B averaged 4 mm of proximal radial migration (p < 0.01), while Group C demonstrated >6 mm of migration (p < 0.01). Conclusion: In the setting of a non-repairable radial head, the RAIL test may provide a more objective means of assessing for Essex-Lopresti injuries.
KW - Essex lopresti
KW - Interosseous membrane
KW - Proximal radial migration
KW - RAIL
KW - Radial head
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U2 - 10.1016/j.jor.2018.01.013
DO - 10.1016/j.jor.2018.01.013
M3 - Review article
C2 - 29657444
AN - SCOPUS:85041395784
SN - 0972-978X
VL - 15
SP - 78
EP - 80
JO - Journal of Orthopaedics
JF - Journal of Orthopaedics
IS - 1
ER -