Bachy M, Leroux J, Pegot A, Abu Amara S, Lechevallier J, Bachy B
Clinique chirurgicale infantile, CHU Charles-Nicolle, 1 rue de Germont, 76231 Rouen cedex, France.
Arch Pediatr. 2012 Jun;19(6):624-7. doi: 10.1016/j.arcped.2012.03.007. Epub 2012 May 5.
We report the case of a 13-year-old boy with a traumatic elbow dislocation, open stage 2 (Cauchoix and Duparc), with distal ischemia. Exposure of the neurovascular humeral bundle through the wound accentutated the clinical emergency. This clinical observation consisted of elbow dislocation with all severity criteria: (i) opening of the skin, (ii) association with a fracture of the medial humeral epicondyle, and (iii) neurological deficit in the territory of the median nerve. The purpose of this report is to remind physicians that no investigation should delay surgery in elbow dislocation. Despite initial distal ischemia, no vascular exploration is required. Early reduction of the disloction is the key point of care.
我们报告了一例13岁男孩创伤性肘关节脱位的病例，处于开放二期（考乔克斯和迪帕克分类），伴有远端缺血。通过伤口暴露神经血管肱骨束加重了临床急症。该临床观察包括符合所有严重程度标准的肘关节脱位：（i）皮肤开放性伤口，（ii）合并肱骨内上髁骨折，以及（iii）正中神经支配区域的神经功能缺损。本报告的目的是提醒医生，对于肘关节脱位，任何检查都不应延误手术。尽管最初存在远端缺血，但无需进行血管探查。早期复位脱位是治疗的关键。
