Asadollahi Saeed, Shepherd David, Hau Raphael C
Department of Orthopaedics, Northern Hospital, 185 Cooper Street, Epping, VIC 3076, Australia.
Int J Surg Case Rep. 2013;4(8):748-52. doi: 10.1016/j.ijscr.2013.04.032. Epub 2013 May 4.
Galeazzi fracture associated with ipsilateral posterior elbow dislocation and radial head fracture is a rare pattern of injury. Few reports exist that describes this injury pattern and its treatment. We describe a case report of simultaneous occurrence of Galeazzi fracture and ipsilateral dislocation of elbow.
A 58 year-old female presented with Galeazzi fracture and posterior elbow dislocation associated with radial head fracture of left upper extremity. This was managed with closed reduction of the elbow, open reduction and internal fixation of the radial shaft fracture and K-wire stabilisation of the unstable distal radioulnar joint. Prophylactic fasciotomy was performed. At 10 months follow-up, the outcome was favourable with the American shoulder and elbow surgeon score of 92 and the disabilities of the arm, shoulder and hand score of 18.
The presumed mechanism of the injury was a forceful axial loading of a hyperpronated forearm and extended elbow. Our literature review shows that this pattern of injury occurs as a result of high energy trauma in young individuals, and successful outcome can be achieved by addressing each component of this complex injury individually.
Simultaneous occurrence of elbow dislocation and Galeazzi fracture seems to be the result of extreme axial force and unique position of upper extremity at the time of impact. Individualised approach to each component of this injury can result in favourable outcome.
盖氏骨折合并同侧肘关节后脱位及桡骨头骨折是一种罕见的损伤类型。关于这种损伤类型及其治疗的报道很少。我们描述一例同时发生盖氏骨折和同侧肘关节脱位的病例报告。
一名58岁女性因左上肢盖氏骨折、肘关节后脱位合并桡骨头骨折就诊。治疗方法为肘关节闭合复位、桡骨干骨折切开复位内固定以及对不稳定的下尺桡关节进行克氏针固定。进行了预防性筋膜切开术。随访10个月时,结果良好,美国肩肘外科医师评分92分,上肢、肩部和手部功能障碍评分18分。
推测的损伤机制是前臂极度旋前和肘关节伸展时的强力轴向负荷。我们的文献回顾表明,这种损伤类型发生于年轻个体的高能创伤,通过分别处理这种复杂损伤的各个组成部分可取得成功的结果。
肘关节脱位和盖氏骨折同时发生似乎是极端轴向力和上肢在撞击时的独特位置所致。对这种损伤的各个组成部分采取个体化治疗方法可取得良好结果。