The interosseous membrane of the forearm connects the radius and ulna along their lengths, transferring approximately 80 percent of the axial wrist load from the radius to the ulna through its central band. The central band runs obliquely from the distal radius to the proximal ulna and is the primary load-transfer structure. Essex-Lopresti injury combines radial head fracture with interosseous membrane disruption and DRUJ dislocation, creating longitudinal forearm instability.
| Origin | Interosseous border of the radius |
|---|---|
| Insertion | Interosseous border of the ulna |
| Actions | Transfers axial load from the radius to the ulna, stabilises the radioulnar relationship, and provides attachment surfaces for deep forearm muscles |
|---|
Essex-Lopresti injury from axial loading of the forearm is a complex injury that is frequently underdiagnosed because the IOM disruption is invisible on radiographs and the DRUJ dislocation may be subtle. Failure to recognise and treat the IOM component allows the radius to migrate proximally after radial head excision, causing progressive DRUJ and wrist pain. Radial head replacement rather than simple excision is essential in Essex-Lopresti injuries.
Combined radial head fracture, interosseous membrane disruption, and DRUJ dislocation producing longitudinal forearm instability that requires radial head replacement and IOM reconstruction for definitive treatment.
