Ramesh Subramaniam, Lim Yi-Jia
Department of Orthopaedic Surgery, Tan Tock Seng Hospital, 11, Jalan Tan Tock Seng, Singapore, 308433, Singapore,
Strategies Trauma Limb Reconstr. 2011 Aug;6(2):97-101. doi: 10.1007/s11751-011-0112-5. Epub 2011 Jul 20.
We illustrate a rare complex dislocation of the elbow involving a posterior ulno-humeral dislocation associated with open diaphyseal fracture of the ulna, radial shaft fracture, Type 1 coronoid fracture and neuropraxia of the deep branch of the radial nerve. The isolated ulno-humeral dislocation without radio-capitellar involvement, and ulnar diaphyseal fracture, makes this "reverse Monteggia" type of injury pattern very unique. This patient was managed with an initial reduction of his ulno-humeral joint and stabilization of his radius and ulna fractures. He underwent a delayed medial collateral ligament reconstruction a few days later. His fractures went on to unite fully, his elbow joint remained stable, and he achieved good range of motion of his elbow.
我们展示了一例罕见的复杂肘关节脱位,包括尺骨肱骨关节后脱位,伴有尺骨干开放性骨折、桡骨干骨折、Ⅰ型冠突骨折以及桡神经深支神经失用。单纯的尺骨肱骨关节脱位而无桡骨头参与,以及尺骨干骨折,使得这种“反孟氏”型损伤模式非常独特。该患者最初接受了尺骨肱骨关节复位及桡骨和尺骨骨折固定治疗。几天后,他接受了延迟内侧副韧带重建手术。他的骨折完全愈合,肘关节保持稳定,并且肘关节活动范围良好。