Department of Surgery, St Elisabeth Hospital, Tilburg, The Netherlands.
J Orthop Trauma. 2011 Jan;25(1):e5-8. doi: 10.1097/BOT.0b013e3181f8d9a8.
A divergent dislocation of the elbow is a very rare injury, and only a few cases have been described in the literature. It is characterized as a dorsal dislocation of the ulnohumeral joint combined with a lateral dislocation of the proximal radius. All three articulations of the elbow joint are involved. Like in our case, it can be accompanied by an avulsion fracture of the coronoid and a distal radius fracture. For correct understanding of the injury, proper radiographic studies are imperative. In contrast to some earlier reports that advise a conservative approach, we performed a very aggressive operative treatment. To ensure anatomic reconstruction of the elbow, surgical exposure of the various injuries was performed first. After gross reduction of the joint dislocation, definitive osteosynthesis of the distal radius fracture was performed. Subsequently, the coronoid process and lateral collateral ligament could be repaired anatomically, improving the stability of the elbow. An uneventful recovery with excellent elbow motion and stability was achieved.
肘关节脱位是一种非常罕见的损伤，文献中仅描述过少数几例。其特征为尺肱关节后脱位合并桡骨近端侧方脱位，累及肘关节的三个关节面。与我们的病例一样，可伴有冠突撕脱骨折和桡骨远端骨折。为了正确理解损伤，必须进行适当的影像学研究。与一些先前建议保守治疗的报告不同，我们采用了非常积极的手术治疗。为了确保肘关节的解剖重建，首先对各种损伤进行手术暴露。在关节脱位的大体复位后，对桡骨远端骨折进行确定性的内固定。随后，可以对冠突和外侧副韧带进行解剖修复，从而提高肘关节的稳定性。患者恢复顺利，肘部活动度和稳定性良好。
