In contrast, diagnosis of IOM injuries in the context of forearm trauma remains challenging. Standard radiographs usually enable the identification of fracture–dislocations of the forearm joint, and/or dislocations of the radial head and caput ulnae. The lockers may be locked, absent, or unstable, with different combinations recognized in many forearm fracture–dislocation patterns. Nonetheless, the distal IOM is considered to be a secondary stabilizer of the distal radioulnar joint when other soft tissue structures of the DRUJ are compromised. The remaining structures of the IOM (distal oblique bundle, proximal oblique cord, and dorsal oblique accessory cord) are not anatomically constant. Additional ligaments, also known as accessory bands, are oriented in the same direction as the central band to complete the middle ligamentous complex of the IOM. The central tendinous portion of the IOM is obliquely oriented, forming an average angle of 20° with the longitudinal axis of the radius and 28° with the longitudinal axis of the ulna. The central band is the widest and thickest part of the IOM, representing the most important anatomic component of the membrane. The structure of the IOM includes five ligaments: central band, accessory band, distal oblique bundle, proximal oblique cord, and dorsal oblique accessory cord. The IOM plays a major role in forearm stability and allows load transfer from the radius to ulna. The forearm joint thus has two anatomical lockers (PRUJ and DRUJ) and one functional locker (MRUJ), allowing stability during pronation and supination of the forearm. Two anatomical joints: the proximal radioulnar joint (PRUJ) and distal radioulnar joint (DRUJ) According to this classification, and similarly to that of the elbow, we could distinguish between simple dislocations and complex dislocations (fracture–dislocations) of the forearm joint. In addition to fracture–dislocations commonly referred to using historical eponyms (Monteggia, Galeazzi, and Essex-Lopresti), our classification system, to the best of the authors’ knowledge, allowed us to include all types of dislocation and fracture–dislocation of the forearm joint reported in literature. Furthermore, we identified a group of three-locker injuries, other than Essex-Lopresti, associated with ulnar and/or radial shaft fracture causing longitudinal instability. We detected rare patterns of two-locker injuries, sometimes referred to using improper terms of variant or equivalent types of Monteggia and Galeazzi injuries. Three historical reviews were added separately to the process. According to exclusion criteria, 44 full-text articles describing atypical forearm fracture–dislocation were included. Eighty hundred eighty-four articles were identified through PubMed, and after bibliographic research, duplication removal, and study screening, 462 articles were selected.
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