Longitudinal instability of the forearm

The Essex Lopresti lesion is a rare triad of injury to the radial head, interosseous membrane of the forearm and distal radio-ulnar joint, which results in longitudinal instability of the radius. If unrecognized this leads to chronic pain and disability which is difficult to salvage. Early recognition and appropriate treatment is therefore desirable to prevent long-term problems. The aim of this article is to review the pathoanatomy of longitudinal radius instability and use the existing literature and authors’ experience to provide recommendations for recognition and treatment of acute and chronic forearm instability, including description of the author’s technique for interosseous membrane reconstruction.