Ray Partha, King Ian Cc, Thomas Philip Stephen William
Plastic Surgery, St. George's University Hospital, London, UK.
St. George's University Hospital, London, UK.
BMJ Case Rep. 2019 Mar 22;12(3):e226724. doi: 10.1136/bcr-2018-226724.
A 10-year-old boy struck a car bonnet following which his left shoulder got pinned under the wheel. No life-threatening injuries were identified. However, the patient sustained extensive abrasions to the back and the left shoulder, a closed deformity of the left clavicle and a swollen, but stable right knee. The patient was neurovascularly intact globally and all joints had a full range of motion. Plain radiographs suggested a possible greenstick fracture of the left clavicle, but also free gas within the left glenohumeral joint. Concern was raised of an unidentified open injury to the joint. CT was supportive of the finding of gas within the left glenohumeral joint, but ruled out the possible greenstick fracture as a spurious finding. There were no other injuries. The gas was within the left glenohumeral joint and was consistent with vacuum phenomenon. The injury was treated expectantly and the child made a full recovery.
一名10岁男孩撞到汽车引擎盖，随后其左肩被车轮卡住。未发现危及生命的损伤。然而，患者背部和左肩有大面积擦伤，左锁骨闭合性畸形，右膝肿胀但稳定。患者全身神经血管功能完好，所有关节活动范围正常。X线平片提示左锁骨可能有青枝骨折，同时左盂肱关节内有游离气体。有人担心关节存在未被发现的开放性损伤。CT支持左盂肱关节内有气体的发现，但排除了可能的青枝骨折，认为是假阳性结果。没有其他损伤。气体位于左盂肱关节内，符合真空现象。对该损伤采取保守治疗，患儿完全康复。
