The forearm interosseous membrane connects the radius and ulna through a fibrous sheet whose fibres run obliquely (distal-to-radial direction) to transfer radial load to the ulna. The central band is its strongest component and the primary longitudinal stabiliser. Essex-Lopresti lesion (radial head fracture + interosseous membrane disruption + DRUJ dislocation) produces proximal radius migration without radial head arthroplasty reconstruction.
| Origin | Interosseous border of the radius (anterior oblique band, central band, accessory band) |
|---|---|
| Insertion | Interosseous border of the ulna |
| Actions | Transfers load from the radius to the ulna; longitudinal forearm stability (Essex-Lopresti lesion when disrupted); muscle attachment for deep forearm compartments |
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Essex-Lopresti lesion diagnosis requires assessing DRUJ stability after every comminuted radial head fracture — if the interosseous membrane is disrupted, radial head excision alone allows proximal radius migration and DRUJ dysfunction. The IOM is assessed by the radius pull test under fluoroscopy. Chronic IOM disruption produces ulnar-sided wrist pain from DRUJ dysfunction and forearm rotation restriction.
Combined radial head fracture, IOM rupture, and DRUJ dislocation requiring radial head arthroplasty to prevent proximal radius migration.
