Polat Barış, Özmanevra Ramadan, Aydın Deniz, Sarı Enes, Yalçınozan Mehmet
Near East University Orthopaedics and Traumatology Department, Nicosia, Northern Cyprus, Mersin 10, Turkey.
Dr. Suat Günsel Kyrenia University Orthopaedics and Traumatology Department, Kyrenia, Northern Cyprus, Mersin 10, Turkey.
Case Rep Orthop. 2018 Jun 24;2018:6024057. doi: 10.1155/2018/6024057. eCollection 2018.
In this paper, we report a pregnant woman with a missed capitellar fracture of the elbow, who was treated successfully with open reduction and internal fixation using two headless screws. A 29-year-old 6-month pregnant woman presented to the emergency department due to a history of falling on her outstretched hand. A long-arm splint was applied without radiological evaluation due to pregnancy. She came to the orthopaedics and traumatology outpatient clinic 6 weeks after trauma and her examination after splint removal revealed pain and restriction in the elbow joint movements. Radiography was taken by using a lead shield in order to protect the fetus. Radiographs showed a displaced osteochondral capitellar fracture. Using the posterolateral approach as described by Kocher, the fracture was fixed using headless canulated compression screws. The follow-up examination showed excellent functional and radiological results. Radiological evaluation should not be avoided in case of obvious fracture findings after trauma even in case of pregnancy. It is also highlighted that good results in terms of union and functional recovery can be achieved with open reduction and headless compression screw fixation followed by early rehabilitation even in delayed treatment of capitellum fractures.
在本文中，我们报告了一名漏诊的肘部肱骨小头骨折孕妇，通过使用两枚无头螺钉进行切开复位内固定成功治疗。一名29岁、怀孕6个月的孕妇因伸直手摔倒的病史就诊于急诊科。由于怀孕，未进行放射学评估就应用了长臂夹板。外伤6周后她来到骨科和创伤门诊，拆除夹板后的检查发现肘关节活动时有疼痛和受限。为保护胎儿，使用铅屏蔽进行了X线摄影。X线片显示肱骨小头骨折移位。采用科赫尔（Kocher）描述的后外侧入路，使用无头空心加压螺钉固定骨折。随访检查显示功能和影像学结果均极佳。即使在怀孕情况下，外伤后如有明显骨折表现，也不应避免进行放射学评估。还强调了即使在肱骨小头骨折延迟治疗的情况下，通过切开复位和无头加压螺钉固定并早期康复，在愈合和功能恢复方面也可取得良好效果。
