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一名业余滑雪板爱好者肘部脱位合并关节内碎片残留、滑车骨折及同侧桡骨远端骨折的罕见组合:病例报告及文献复习

Unusual combination of elbow dislocation with a retained intraarticular fragment and trochlear fracture and ipsilateral distal radius fracture in an amateur snowboarder: A case report and review of literatures.

作者信息

Moon Dong Kyu, Hwang Sun Chul, Yoo Jun Il, Park Jin Sung

机构信息

Department of Orthopaedic Surgery and Institute of Health Sciences, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea.

Department of Orthopaedic Surgery and Institute of Health Sciences, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea.

出版信息

Int J Surg Case Rep. 2019;55:196-201. doi: 10.1016/j.ijscr.2019.01.039. Epub 2019 Feb 1.

Abstract

INTRODUCTION

The most common damage caused by snowboarding is wrist injury. However, Elbow injuries are relatively rare. In general, elbow dislocation with ipsilateral distal radius fracture is also very rare.

PRESENTATION OF CASE

We present an 18-year-old right hand dominant male with distal radius extra-articular fracture and elbow fracture dislocation. Computed tomographic scan and Magnetic resonance image of elbow joint showed retained intra-articular fragment, trochlear fracture, and the humeral attachment site of lateral collateral ligament (LCL) with rupture. The ruptured LCL was repaired, and then, the distal radius fracture was fixed with a volar distal radius locking plate. At one year after surgery, the patient did not complain of any subjective symptoms or functional deficit.

DISCUSSION

The injury mechanism would fall into the outstretched arm state, leading first to hyperextension of the wrist, resulting in fracture of the distal radius. The remaining force is then applied to the elbow joint by an external rotation and valgus moment arm, resulting in the rupture of the LCL of the elbow joint. In this state, the remaining force is transmitted through the olecranon to the trochlea as a shear force, resulting in osteochondral fracture and subsequent dislocation of the elbow joint.

CONCLUSION

Combined injury of extremity from snowboarding is relatively rare, but we experienced a case of elbow dislocation combined with distal radius fracture caused by fall on outstretched hand on the snow surface during snowboarding in a young adult.

摘要

引言

单板滑雪造成的最常见损伤是手腕损伤。然而,肘部损伤相对少见。一般来说,伴有同侧桡骨远端骨折的肘关节脱位也非常罕见。

病例介绍

我们报告一名18岁右利手男性,患有桡骨远端关节外骨折和肘关节骨折脱位。肘关节计算机断层扫描和磁共振成像显示关节内有残留碎片、滑车骨折以及外侧副韧带(LCL)肱骨附着部位断裂。修复断裂的LCL后,用掌侧桡骨远端锁定钢板固定桡骨远端骨折。术后一年,患者未诉任何主观症状或功能缺陷。

讨论

损伤机制为手臂伸展状态,首先导致手腕过度伸展,造成桡骨远端骨折。剩余力量随后通过外旋和外翻力矩作用于肘关节,导致肘关节LCL断裂。在此状态下,剩余力量作为剪切力通过尺骨鹰嘴传递至滑车,导致骨软骨骨折及随后的肘关节脱位。

结论

单板滑雪导致的肢体联合损伤相对少见,但我们遇到一例年轻成人单板滑雪时因在雪面上伸展手摔倒而造成肘关节脱位合并桡骨远端骨折的病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4aa1/6374697/e01333d893eb/gr1.jpg

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