The crisscross injury mechanism in forearm injuries.
BACKGROUND
A new mechanism of injury of the forearm bones, crisscross injury, is described. It is more common than the Essex-Lopresti fracture dislocation. The old concept of isolated injury of one side of the radioulnar joint may be challenged. It often occurs in Mason type II fracture dislocation of the radial head or dislocation of radioulnar joints.


METHODS
The first part was a cadaveric study of the crisscross injury of forearms. The second part was a clinical study of the crisscross injury in some cases of Mason type II fracture radial head and double dislocation of the radioulnar joint.


RESULTS
The cadaveric study confirmed a stable crisscross fracture dislocation injury with intact interosseous membrane. The clinical study echoed the presence of this injury by imaging techniques.


CONCLUSIONS
The crisscross injury mechanism explains the mirror pathogenesis of the traumatic fracture dislocation of the distal and proximal radioulnar joints with intact shaft of the radius and ulna. Co-existing subluxation or dislocation of the other radioulnar articulation must not be overlooked in cases of fracture dislocation of one radioulnar joint. Two types of crisscross injury of forearm bones are proposed.
Leung
Y F
YF
Orthopaedics and Traumatology Department, Yan Chai Hospital, Tsuen Wan, NT, Hong Kong, China. lyf888@ctimail3.com
Ip
S P S
SP
Ip
W Y
WY
Kam
W L
WL
Wai
Y L
YL
D000328:Adult; D002102:Cadaver; D005260:Female; D005543:Forearm Injuries / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D004204:Joint Dislocations / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D011885:Radius Fractures / Q000209:etiology / Q000503:physiopathology*; D014458:Ulna Fractures / Q000209:etiology / Q000503:physiopathology*