Posterior Dislocation Of Elbow Joint Research Articles

Closed reduction and percutaneous pinning for treatment of unstable lateral condyle fractures of the humerus in children.

In the past, obviously displaced lateral condyle fractures of the humerus in children were treated satisfactorily with open reduction and internal fixation (ORIF). However, in recent years, more studies have mentioned closed reduction and percutaneous pinning (CRPP) of these fractures. In this retrospective investigation, the radiographic and clinical results of patients with these fractures that were initially managed with CRPP were newly classified. We classified these fractures into three groups according to the degree and pattern of fracture displacement as identified on four radiographic images. In Type I, the fracture is unstable and displacement is ≥2 mm; In Type II degree I, the fracture is unstable and displacement is >2 mm, with single rotation of fragment; In Type II degree II, the fracture is unstable and displacement is >2 mm, with single rotation of fragment, with rotation of fragment and antero-proximal displacement; In Type III, the fracture is unstable and displacement is >2 mm, with posterior dislocation of elbow joint. We also designed an algorithm for closed reduction of these fractures according to this new classification. We retrospectively analyzed the radiographic and clinical results of 37 unstable fractures (in 22 boys and 15 girls) that were treated with closed reduction. Twenty-one of 25 (84.0%) type I fractures, which could have been reduced to within 2 mm of residual displacement, were treated with closed reduction and pinning with 2 or 3 Kirschner wires (K wires). Three of 5 (60.0%) type II degree I, 3 of 4 (75.0%) type II degree II, and 3 of 3 (100%) type III fractures were treated with CRPP. In 4 of 25 (16.0%) type I, 2 of 5 (40.0%) type II degree I and 1 of 4 (25.0%) type II degree II fractures, closed reduction failed, so ORIF was implemented. There were no complications, such as nonunion, osteonecrosis of the capitellum, superficial or deep infection, malunion, cubitus varus or valgus, or early physeal arrest. Although the management of type III fractures may not be more difficult than type II fractures with a rotated fracture fragment, as elbow dislocations are usually easy reducible. This retrospective study showed that type III fractures should not be ignored as a lateral condyle fracture that can be cured with CRPP and that lateral humeral condyle fractures with obvious displacement and rotation can be initially treated with CRPP to achieve satisfactory recovery of the elbow. Kirschner wire (K wire) fixation is recommended to avoid reoperation or anesthesia for hardware removal.

Median Nerve Palsy following Posterior Dislocation of Elbow Joint: A Case Report


 
 
 
 Median nerve entrapment as a consequence of posterior dislocation of elbow is a rare. The diagnosis is usually missed or delayed. We present a case of median nerve entrapment following dislocation of elbow with medial epicondyle fracture in a 12 years old male child. After 10 days of reduction, the child presented with neurological deficit showing median nerve palsy. Nerve conduction study showed total denervation of median nerve. Nerve release was done by breaking the callus around medial epicondyle with neurolysis. Median nerve entrapment after the elbow dislocation is a very rare entity. High index of suspicion and timely intervention is helpful in diagnosing the case and managing with a good functional recovery.
 
 
 

An analysis of clinical effects of 9 cases of fracture of ulna coronoid process with posterior dislocation of elbow joint

目的 探讨肘关节后脱位并尺骨冠状突骨折的治疗方法.方法总结2000年3月～2003年5月9例肘关节后脱位合并尺骨冠状突骨折患者的治疗经验,根据骨折类型分别采用内外侧入路对8例患者进行手术治疗,术后配合早期功能锻炼.结果所有患者随访8～24个月,根据HSS评分标准,优5例(55.6%),良2例(22.2%),一般2例(22.2%),优良率77.8%,无严重肘关节并发症发生.结论选择恰当的手术入路和早期功能锻炼是提高该类骨折效果的关键。

Posterior Dislocation of Elbow Joint with Fracture of Radial Head and Coronoid Process (Terrible triad of Elbow Fracture and Dislocation): case report

Posterior Dislocation of Elbow Joint with Fracture of Radial Head and Coronoid Process (Terrible triad of Elbow Fracture and Dislocation): case report

尺骨かぎ状突起骨折を伴う肘関節脱臼の２例

尺骨かぎ状突起骨折を伴う肘関節脱臼の２例