Greene Ryan M, Bader Jacqueline E, Mauter Libby, Sears Benjamin W, Tirre Conrad J, Hatzidakis Armodios M
Mayo Clinic, Rochester, Minnesota.
Western Orthopaedics, Denver, Colorado.
JBJS Case Connect. 2018 Oct-Dec;8(4):e92. doi: 10.2106/JBJS.CC.17.00252.
A 49-year-old right-hand-dominant man sustained an auger-related injury that resulted in open dislocation at the left wrist and palm, with complete amputation of the distal aspect of the forearm and the hand. The injury at the elbow included instability with an ulnar coronoid fracture, posterior dislocation of the ulna, and posterolateral dislocation of the radius. To restore stability of the forearm stump and elbow, we performed a complete resection of the radius, open reduction and internal fixation of the coronoid tip, a repair of the lateral collateral ligament, and transfer of the distal biceps tendon to the coronoid.
The procedure stabilized the elbow, allowing for early mobilization. The patient was eventually fitted with a prosthesis that allowed him to return to full-time manual labor in a rural setting.
一名49岁惯用右手的男性遭受了螺旋钻相关损伤,导致左手腕和手掌开放性脱位,前臂远端和手部完全离断。肘部损伤包括尺骨冠状突骨折伴不稳定、尺骨后脱位以及桡骨后外侧脱位。为恢复前臂残端和肘部的稳定性,我们对桡骨进行了完整切除,对冠状突尖端进行了切开复位内固定,修复了外侧副韧带,并将肱二头肌远端肌腱转移至冠状突。
该手术稳定了肘部,便于早期活动。患者最终安装了假肢,使其能够在农村环境中重新从事全职体力劳动。