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近端桡尺关节脱位伴尺神经卡压漏诊:儿童的一种罕见损伤。

Missed proximal radioulnar joint translocation with ulnar nerve entrapment: an unusual injury in a child.

作者信息

Najid Hamzah, Abdul Rashid Abdul Halim, Ibrahim Sharaf

机构信息

Department of Orthopaedics and Traumatology, Faculty of Medicine, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia.

出版信息

J Pediatr Orthop B. 2019 Jan;28(1):79-84. doi: 10.1097/BPB.0000000000000556.

Abstract

Traumatic elbow dislocation in a child is rare, and it is usually associated with fractures. Simultaneous proximal radioulnar joint (PRUJ) translocation with ulnar nerve palsy is even rarer. We report an unusual case of a missed PRUJ translocation with ulnar nerve entrapment in a 10-year-old child. The key to diagnosing the translocation is the position of the proximal radius, which lies medial to the ulna. This was treated by open reduction and release of the entrapped nerve. The ulnar nerve palsy recovered fully at the 1-year follow-up. Although PRUJ translocation with ulnar nerve entrapment is a rare injury, a successful outcome is possible with timely open reduction and release of the ulnar nerve.

摘要

儿童创伤性肘关节脱位很少见,且通常伴有骨折。同时发生近端桡尺关节(PRUJ)移位并伴有尺神经麻痹的情况更为罕见。我们报告了一例不同寻常的病例,一名10岁儿童漏诊了PRUJ移位并伴有尺神经卡压。诊断该移位的关键在于桡骨近端的位置,其位于尺骨内侧。该病例通过切开复位和松解卡压神经进行治疗。在1年的随访中,尺神经麻痹完全恢复。尽管PRUJ移位并伴有尺神经卡压是一种罕见损伤,但及时进行切开复位和尺神经松解仍有可能获得成功的治疗结果。

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