Fractures: Essex-Lopresti injury: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Orthopaedics · Fractures: Essex-Lopresti injury

Sample item

After a fall from a height onto the hand, a patient has a comminuted radial head fracture with wrist pain and proximal migration of the radius. Which injury is suspected?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Essex-Lopresti injury with interosseous membrane and distal radioulnar joint disruption

Essex-Lopresti injury combines a radial head fracture with disruption of the interosseous membrane and distal radioulnar joint, allowing proximal migration of the radius. Excising the radial head in this setting worsens the instability.

Option by option

  • A. Galeazzi fracture-dislocation

    Galeazzi is a radial shaft fracture with DRUJ dislocation.

  • B. Monteggia fracture-dislocation

    Monteggia is an ulnar shaft fracture with radial head dislocation.

  • C. Isolated Mason type I radial head fracture

    An isolated undisplaced radial head fracture does not cause proximal radial migration.

  • D. Essex-Lopresti injury with interosseous membrane and distal radioulnar joint disruption (correct)

    Correct. Radial head fracture plus wrist pain with axial instability points to this injury.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is D, Essex-Lopresti injury with interosseous membrane and distal radioulnar joint disruption. Essex-Lopresti injury combines a radial head fracture with disruption of the interosseous membrane and distal radioulnar joint, allowing proximal migration of the radius.

Why is "Galeazzi fracture-dislocation" not the answer?

Galeazzi is a radial shaft fracture with DRUJ dislocation.

Why is "Monteggia fracture-dislocation" not the answer?

Monteggia is an ulnar shaft fracture with radial head dislocation.

Why is "Isolated Mason type I radial head fracture" not the answer?

An isolated undisplaced radial head fracture does not cause proximal radial migration.

What concept does this question test?

It tests Fractures: Essex-Lopresti injury in Orthopaedics. Excising the radial head in this setting worsens the instability.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Fractures: Essex-Lopresti injury?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.