CC BY-NC-ND 4.0 · Rev Iberoam Cir Mano 2019; 47(02): 131-136
DOI: 10.1055/s-0039-1688568
Case Report | Relato de Caso
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Elbow Dislocation with Ipsilateral Radial Shaft Fracture – A Case Report

Dislocación del codo con fractura de eje radial ipsilateral – reporte de un caso
Marcio Aurelio Aita
3  Department of Orthopedic and Trauma Surgery, Division of Hand and Microsurgery, Faculdade de Medicina do ABC, Santo André, SP, Brazil
,
Ricardo Kaempf de Oliveira
1  Hospital Santa Casa de Misericórdia, Porto Alegre, RS, Brazil
2  Hospital Mãe de Deus, Porto Alegre, RS, Brazil
,
Rafael Pêgas Praetzel
1  Hospital Santa Casa de Misericórdia, Porto Alegre, RS, Brazil
2  Hospital Mãe de Deus, Porto Alegre, RS, Brazil
,
Fernando Towata
3  Department of Orthopedic and Trauma Surgery, Division of Hand and Microsurgery, Faculdade de Medicina do ABC, Santo André, SP, Brazil
,
Pedro Jose Delgado
4  Universidade CEU San Pablo, Hospital Universitário Madrid Montepríncipe, Boadilla del Monte, Madrid, Spain
,
5  Hospital Santa Casa de Misericórdia, Porto Alegre, RS, Brazil
› Author Affiliations
Funding None.
Further Information

Publication History

21 November 2018

25 March 2019

Publication Date:
31 May 2019 (online)

  

Abstract

Background Posterior dislocation of the elbow associated to a radial shaft fracture is a rare lesion, its treatment is difficult and complicated, and the indications, surgical options, and timing of surgery may vary. In the present case, we performed immediately after the trauma (urgent care) an open reduction internal fixation (ORIF) surgery of the radial fracture by means of a 3.5 mm locking plate, associated to closed elbow reduction and stabilization with dynamic bracing.

Case Report A 26-year-old woman was seen in our service with a traumatic deformity of her right, dominant forearm and elbow after a fall from a balance board and presented with a radial shaft fracture and posterior elbow dislocation. The palmar approach was used and the shaft fracture was fixated. During the radial fracture reduction maneuver, the dislocation of the elbow was spontaneously reduced. At 1 year postoperatively, the patient showed good wrist, forearm, and elbow range of motion (ROM). Disabilities of the arm, shoulder and hand (DASH) score of 5, visual analogue scale (VAS) of 0, and grip strength of 92%, as compared with the nonaffected side.

Clinical Relevance Nowadays, case reports of concomitant, ipsilateral multiple injuries that uncommonly occur together in a single traumatic episode are very rare. The awareness of this association for early recognition is of paramount significance for ideal clinical results.

Resumen

Antecedentes La dislocación posterior del codo asociada a una fractura del eje radial es una lesión rara, su tratamiento es difícil y complicado, y las indicaciones, las opciones quirúrgicas y el momento de la cirugía pueden variar. En el presente caso, realizamos inmediatamente después del traumatismo (atención de urgencia) una cirugía de fijación interna con reducción abierta (ORIF) de la fractura radial mediante una placa de bloqueo de 3,5 mm, asociada a la reducción y estabilización del codo cerrado con refuerzo dinámico.

Reporte de caso Una mujer de 26 años fue atendida en nuestro servicio con una deformidad traumática de su derecha, antebrazo dominante y codo después de una caída de una tabla de equilibrio y se presentó con una fractura del eje radial y dislocación posterior del codo. Se utilizó el abordaje palmar y se fijó la fractura del eje. Durante la maniobra de reducción de la fractura radial, la dislocación del codo se redujo espontáneamente. Al año de la operación, el paciente mostró una buena movilidad de la muñeca, el antebrazo y el codo (ROM). La disability for arm, shoulder and hand questionnaire (DASH) obtuvo una puntuación de 5, una escala analógica visual (VAS) de 0 y una fuerza de agarre del 92%, en comparación con el lado no afectado.

Relevancia clínica En la actualidad, los informes de casos de lesiones múltiples ipsilaterales concomitantes que ocurren de manera poco común en un solo episodio traumático son muy raros. El conocimiento de esta asociación para el reconocimiento temprano es de suma importancia para los resultados clínicos ideales.

Note

The research presented here was approved by and was in accordance with the ethical standards of the Faculdade de Medicina do ABC Ethics Committee on human experimentation under the number 160/2007. An informed consent document was provided to the patient, who read and signed it according to her will.


Ethical Approval

The research presented here was approved by and was in accordance with the ethical standards of Ethics Committee of the Faculdade de Medicina do ABC on human experimentation


Informed Consent

An informed consent document was provided to all research participants, who read and signed it according to their will.