Fracture–dislocations of the forearm joint: a systematic review of the literature and a comprehensive locker-based classification system
Abstract Background Monteggia, Galeazzi, and Essex-Lopresti injuries are the most common types of fracture–dislocation of the forearm. Uncommon variants and rare traumatic patterns of forearm fracture–dislocations have sometimes been reported in literature. In this study we systematically review the...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2020-12-01
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| Series: | Journal of Orthopaedics and Traumatology |
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| Online Access: | https://doi.org/10.1186/s10195-020-00562-8 |
| _version_ | 1818905672334442496 |
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| author | Stefano Artiaco Federico Fusini Arman Sard Elisa Dutto Alessandro Massè Bruno Battiston |
| author_facet | Stefano Artiaco Federico Fusini Arman Sard Elisa Dutto Alessandro Massè Bruno Battiston |
| author_sort | Stefano Artiaco |
| collection | DOAJ |
| description | Abstract Background Monteggia, Galeazzi, and Essex-Lopresti injuries are the most common types of fracture–dislocation of the forearm. Uncommon variants and rare traumatic patterns of forearm fracture–dislocations have sometimes been reported in literature. In this study we systematically review the literature to identify and classify all cases of forearm joint injury pattern according to the forearm joint and three-locker concepts. Methods A comprehensive search of the PubMed database was performed based on major pathological conditions involving fracture–dislocation of the forearm. Essex-Lopresti injury, Monteggia and Galeazzi fracture–dislocations, and proximal and/or distal radioulnar joint dislocations were sought. After article retrieval, the types of forearm lesion were classified using the following numerical algorithm: proximal forearm joint 1 [including proximal radioulnar joint (PRUJ) dislocation with or without radial head fractures], middle radioulnar joint 2, if concomitant radial fracture R, if concomitant interosseous membrane rupture I, if concomitant ulnar fracture U, and distal radioulnar joint 3 [including distal radioulnar joint (DRUJ) dislocation with or without distal radial fractures]. Results Eighty hundred eighty-four articles were identified through PubMed, and after bibliographic research, duplication removal, and study screening, 462 articles were selected. According to exclusion criteria, 44 full-text articles describing atypical forearm fracture–dislocation were included. Three historical reviews were added separately to the process. We detected rare patterns of two-locker injuries, sometimes referred to using improper terms of variant or equivalent types of Monteggia and Galeazzi injuries. Furthermore, we identified a group of three-locker injuries, other than Essex-Lopresti, associated with ulnar and/or radial shaft fracture causing longitudinal instability. In addition to fracture–dislocations commonly referred to using historical eponyms (Monteggia, Galeazzi, and Essex-Lopresti), our classification system, to the best of the authors’ knowledge, allowed us to include all types of dislocation and fracture–dislocation of the forearm joint reported in literature. According to this classification, and similarly to that of the elbow, we could distinguish between simple dislocations and complex dislocations (fracture–dislocations) of the forearm joint. Conclusions All injury patterns may be previously identified using an alphanumeric code. This might avoid confusion in forearm fracture–dislocations nomenclature and help surgeons with detection of lesions, guiding surgical treatment. Level of evidence V. |
| first_indexed | 2024-12-19T21:27:03Z |
| format | Article |
| id | doaj.art-ecb526eef2db424a8224293d0175a73e |
| institution | Directory Open Access Journal |
| issn | 1590-9921 1590-9999 |
| language | English |
| last_indexed | 2024-12-19T21:27:03Z |
| publishDate | 2020-12-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Journal of Orthopaedics and Traumatology |
| spelling | doaj.art-ecb526eef2db424a8224293d0175a73e2022-12-21T20:05:07ZengSpringerOpenJournal of Orthopaedics and Traumatology1590-99211590-99992020-12-0121111110.1186/s10195-020-00562-8Fracture–dislocations of the forearm joint: a systematic review of the literature and a comprehensive locker-based classification systemStefano Artiaco0Federico Fusini1Arman Sard2Elisa Dutto3Alessandro Massè4Bruno Battiston5Department of Orthopaedic and Traumatology, Hand and Microsurgery Unit, Orthopaedic and Trauma Centre, AOU Città Della Salute E Della Scienza Di TorinoDepartment of Orthopaedic and Traumatology, Orthopaedic and Trauma Centre, AOU Città Della Salute E Della Scienza Di Torino, University of TurinDepartment of Orthopaedic and Traumatology, Hand and Microsurgery Unit, Orthopaedic and Trauma Centre, AOU Città Della Salute E Della Scienza Di TorinoDepartment of Orthopaedic and Traumatology, Hand and Microsurgery Unit, Orthopaedic and Trauma Centre, AOU Città Della Salute E Della Scienza Di TorinoDepartment of Orthopaedic and Traumatology, Orthopaedic and Trauma Centre, AOU Città Della Salute E Della Scienza Di Torino, University of TurinDepartment of Orthopaedic and Traumatology, Hand and Microsurgery Unit, Orthopaedic and Trauma Centre, AOU Città Della Salute E Della Scienza Di TorinoAbstract Background Monteggia, Galeazzi, and Essex-Lopresti injuries are the most common types of fracture–dislocation of the forearm. Uncommon variants and rare traumatic patterns of forearm fracture–dislocations have sometimes been reported in literature. In this study we systematically review the literature to identify and classify all cases of forearm joint injury pattern according to the forearm joint and three-locker concepts. Methods A comprehensive search of the PubMed database was performed based on major pathological conditions involving fracture–dislocation of the forearm. Essex-Lopresti injury, Monteggia and Galeazzi fracture–dislocations, and proximal and/or distal radioulnar joint dislocations were sought. After article retrieval, the types of forearm lesion were classified using the following numerical algorithm: proximal forearm joint 1 [including proximal radioulnar joint (PRUJ) dislocation with or without radial head fractures], middle radioulnar joint 2, if concomitant radial fracture R, if concomitant interosseous membrane rupture I, if concomitant ulnar fracture U, and distal radioulnar joint 3 [including distal radioulnar joint (DRUJ) dislocation with or without distal radial fractures]. Results Eighty hundred eighty-four articles were identified through PubMed, and after bibliographic research, duplication removal, and study screening, 462 articles were selected. According to exclusion criteria, 44 full-text articles describing atypical forearm fracture–dislocation were included. Three historical reviews were added separately to the process. We detected rare patterns of two-locker injuries, sometimes referred to using improper terms of variant or equivalent types of Monteggia and Galeazzi injuries. Furthermore, we identified a group of three-locker injuries, other than Essex-Lopresti, associated with ulnar and/or radial shaft fracture causing longitudinal instability. In addition to fracture–dislocations commonly referred to using historical eponyms (Monteggia, Galeazzi, and Essex-Lopresti), our classification system, to the best of the authors’ knowledge, allowed us to include all types of dislocation and fracture–dislocation of the forearm joint reported in literature. According to this classification, and similarly to that of the elbow, we could distinguish between simple dislocations and complex dislocations (fracture–dislocations) of the forearm joint. Conclusions All injury patterns may be previously identified using an alphanumeric code. This might avoid confusion in forearm fracture–dislocations nomenclature and help surgeons with detection of lesions, guiding surgical treatment. Level of evidence V.https://doi.org/10.1186/s10195-020-00562-8Forearm jointForearm fracture–dislocation classificationMonteggiaGaleazziEssex-Lopresti |
| spellingShingle | Stefano Artiaco Federico Fusini Arman Sard Elisa Dutto Alessandro Massè Bruno Battiston Fracture–dislocations of the forearm joint: a systematic review of the literature and a comprehensive locker-based classification system Journal of Orthopaedics and Traumatology Forearm joint Forearm fracture–dislocation classification Monteggia Galeazzi Essex-Lopresti |
| title | Fracture–dislocations of the forearm joint: a systematic review of the literature and a comprehensive locker-based classification system |
| title_full | Fracture–dislocations of the forearm joint: a systematic review of the literature and a comprehensive locker-based classification system |
| title_fullStr | Fracture–dislocations of the forearm joint: a systematic review of the literature and a comprehensive locker-based classification system |
| title_full_unstemmed | Fracture–dislocations of the forearm joint: a systematic review of the literature and a comprehensive locker-based classification system |
| title_short | Fracture–dislocations of the forearm joint: a systematic review of the literature and a comprehensive locker-based classification system |
| title_sort | fracture dislocations of the forearm joint a systematic review of the literature and a comprehensive locker based classification system |
| topic | Forearm joint Forearm fracture–dislocation classification Monteggia Galeazzi Essex-Lopresti |
| url | https://doi.org/10.1186/s10195-020-00562-8 |
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