Redjil Noureddine, Dabire Mwinyanne Narcisse, Weber Pierre
Service d'Orthopédie et de Traumatologie, Centre Hospitalier de Mulhouse, Mulhouse, France.
Pan Afr Med J. 2015 Jun 16;21:128. doi: 10.11604/pamj.2015.21.128.6553. eCollection 2015.
Elbow's dislocations of the child are rare injuries. Its associated injuries such as the opening and the distal ischemia are an extreme therapeutic emergency. One case of open elbow dislocation with distal ischemia in a 10-year-old child is reported. In the clinical examination, there is a deformity of the elbow, a wound showing the cartilaginous distal humerus with the brachial artery under tension on the trochlea that creates a beginning distal ischemia and hypoesthesia in the territory of the median nerve. The surgical health care included a careful debridement, a reduction and scanning of the neurovascular bundle of humerus with reappearance of pulses after 45 minutes. After the last follow-up at three months, the child's examination does not show any neurovascular disorder with a steady elbow. The functional prognosis depends mainly on the reduction time, the importance of neurovascular injuries and the skin opening.
儿童肘部脱位是罕见的损伤。其相关损伤，如开放性损伤和远端缺血，是极其紧急的治疗情况。本文报告了一例10岁儿童开放性肘部脱位伴远端缺血的病例。临床检查发现肘部畸形，有一伤口，可见肱骨远端软骨，肱动脉在滑车处受张力，导致开始出现远端缺血以及正中神经支配区域感觉减退。手术治疗包括仔细清创、复位以及探查肱骨神经血管束，45分钟后脉搏恢复。在三个月的最后一次随访中，患儿检查未发现任何神经血管紊乱，肘部稳定。功能预后主要取决于复位时间、神经血管损伤的严重程度以及皮肤开放性。
