Osman Walid, Braiki Meriem, Alaya Zeineb, Naouar Nader, Ben Ayeche Mohamed
Department of Orthopedic Surgery, Sahloul University Hospital, Sousse, Tunisia.
Department of Rheumatology, Farhat Hached University Hospital, Sousse, Tunisia.
Case Rep Orthop. 2016;2016:7631425. doi: 10.1155/2016/7631425. Epub 2016 Dec 14.
. Isolated fracture of the trochlea is an uncommon condition requiring a particular mechanism of injury. Its association with a distal radial fracture is rare. We aimed through this case report to identify the injury mechanism and to assess surgical outcomes. . We report a 26-year-old female who was admitted to our department for elbow trauma following an accidental fall on her outstretched right hand with her elbow extended and supinated. On examination, the right elbow was swollen with tenderness over the anteromedial aspect of the distal humerus. The elbow range was restricted. Standard radiographs showed an intra-articular half-moon-shaped fragment lying proximal and anterior to the distal humerus. There was a comminuted articular fracture of the distal radius with an anterior displacement. A computed tomography revealed an isolated shear fracture of the trochlea without any associated lesion of the elbow. The patient was surgically managed. Anatomical reduction was achieved and the fracture was fixed with 2 Kirschner wires. The distal radial fracture was treated by open reduction and plate fixation. The postoperative course was uneventful with a good recovery. . Knowledge of such entity would be useful to indicate the suitable surgical management and eventually to obtain good functional outcomes.
滑车孤立性骨折是一种罕见的情况，需要特定的损伤机制。它与桡骨远端骨折的关联很少见。我们旨在通过本病例报告来确定损伤机制并评估手术效果。
我们报告一名26岁女性，因右上肢伸直位摔倒，肘部伸展并旋后，导致肘部外伤而入住我院。检查时，右肘肿胀，肱骨远端前内侧有压痛。肘关节活动范围受限。标准X线片显示，在肱骨远端近端和前方有一个关节内半月形碎片。桡骨远端有粉碎性关节骨折并向前移位。计算机断层扫描显示滑车孤立性剪切骨折，肘部无任何相关病变。患者接受了手术治疗。实现了解剖复位，并用2根克氏针固定骨折。桡骨远端骨折采用切开复位钢板固定治疗。术后过程顺利，恢复良好。
了解这种情况有助于指导合适的手术治疗，并最终获得良好的功能结果。
