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外侧副韧带复合体撕脱骨折及关节内异物嵌入后的肘关节不稳定:一种罕见的表现。

Elbow instability following lateral collateral ligament complex avulsion fracture and joint interposition: an uncommon presentation.

作者信息

Karthik Karuppaiah, Kasilingam Vidhya, Othieno-P'otonya Kerementi

机构信息

Department of Orthopaedics, King's College Hospital NHS Foundation Trust, London, UK.

King's College London School of Medical Education, London, UK.

出版信息

BMJ Case Rep. 2018 Sep 1;2018:bcr-2018-225551. doi: 10.1136/bcr-2018-225551.

Abstract

The lateral collateral ligament (LCL) complex of the elbow is a capsuloligamentous structure, critical for elbow stability. Though isolated ligamentous injuries have been reported in literature, there are no studies reporting avulsion fractures of the lateral ligamentous complex of the elbow with joint incarceration in a child. An 11-year-old boy presented to the emergency department after a fall from height, with pain and swelling to the lateral side of his left elbow. Radiographs established a fracture of the lateral condyle and CT imaging confirmed an avulsion of the lateral ligamentous complex, with fragments in the inferior radiocapitellar joint. Examination under anaesthesia revealed an unstable elbow with restricted extension, and the child underwent joint debridement and open reduction internal fixation of LCL complex with cannulated screws. At the final follow-up at 15 months, the child regained preinjury level of function.

摘要

肘关节外侧副韧带(LCL)复合体是一种关节囊韧带结构,对肘关节稳定性至关重要。尽管文献中已报道过孤立的韧带损伤,但尚无关于儿童肘关节外侧韧带复合体撕脱骨折伴关节嵌顿的研究。一名11岁男孩从高处坠落后来到急诊科,其左肘外侧疼痛肿胀。X线片显示外侧髁骨折,CT成像证实外侧韧带复合体撕脱,骨折碎片位于桡骨小头下关节。麻醉下检查发现肘关节不稳定,伸展受限,该患儿接受了关节清创术以及使用空心螺钉对LCL复合体进行切开复位内固定。在15个月的最终随访中,患儿恢复到了受伤前的功能水平。

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