Purpose In the last two decades, a strong interest on the interosseous membrane (IOM)
has developed. Methods The authors present a review of the new concepts regarding
the understanding of forearm physiology and pathology, with current trends in the
surgical management of these rare and debilitating injuries. Results Anatomical and
biomechanical studies have clarified the anatomy of forearm constrains and their role
in forearm longitudinal and transverse stability. The radial pull test, a new intraoperative
test, has been developed that might increase the detection on IOM injuries. The forearm
is now considered a "functional unit" and, consequently, a new classification has
been proposed. Uncommon variants and rare patterns of forearm fracture dislocations
have been reported in the literature and could not be classified to those commonly
referred to using eponyms (Monteggia, Galeazzi, Essex-Lopresti). The new Artiaco et
al. classification includes all injury patterns, thus avoids confusion in the nomenclature,
and helps surgeon with detection of lesions and guiding surgical treatment. Conclusion
Based on the new classification and after current literature review, authors propose
a management flowchart for treatment of forearm instability injuries.
