Alencar Neto Jonatas Brito, Costa Cavalcante Maria Luzete, Garrido Renackson Jordelino, Messias da Rocha Pedro Henrique
Departamento de Ortopedia e Traumatologia, Instituto Doutor José Frota, Fortaleza, Brasil.
Departamento de Ortopedia, Universidade Federal do Ceará, Hospital Walter Cantídio, Fortaleza, Brasil.
Rev Bras Ortop (Sao Paulo). 2019 Feb;54(1):73-77. doi: 10.1016/j.rbo.2017.09.015. Epub 2019 Mar 1.
Humeral shaft fractures combined with elbow dislocation and fracture of the distal third of the bones of the forearm are uncommon. No description of this simultaneous association has been found in the same patient. Some studies report the association of these two lesions; however, no reports on the three ipsilateral lesions have been found at the PubMed, Lilacs and Bireme databases. The present report describes a case that occurred in a 13-year-old boy who suffered a fall from a height of approximately three meters and was admitted to a trauma hospital. Radiographs showed an ipsilateral humeral shaft fracture combined with elbow dislocation and a fracture of the distal-third of the bones of the forearm. Under general anesthesia, the injuries were readily reduced by closed manipulation, obtaining a satisfactory reduction of the injuries. Following this, an antebrachiopalmar splint and a commercial Velpeau shoulder immobilizer for the treatment of the humerus diaphyseal fracture were used. After 1 week, the patient presented non-alignment of the diaphyseal fracture of the humerus and was submitted to surgical treatment with flexible retrograde intramedullary nailing, antebrachiopalmar cast, and a commercial Velpeau shoulder immobilizer.
肱骨干骨折合并肘关节脱位及前臂远侧三分之一骨骼骨折并不常见。在同一患者中尚未发现关于这种同时存在的关联的描述。一些研究报告了这两种损伤的关联；然而，在PubMed、Lilacs和Bireme数据库中未发现关于同侧这三种损伤的报告。本报告描述了一例发生在一名13岁男孩身上的病例，该男孩从约三米高处坠落，被送往一家创伤医院。X线片显示同侧肱骨干骨折合并肘关节脱位及前臂远侧三分之一骨骼骨折。在全身麻醉下，通过闭合手法很容易就使损伤得到了复位，损伤复位效果令人满意。在此之后，使用了前臂掌侧夹板和一种用于治疗肱骨干骨折的商用维尔波肩固定器。1周后，患者出现肱骨干骨折对位不良，遂接受了弹性逆行髓内钉内固定、前臂掌侧石膏固定及商用维尔波肩固定器的手术治疗。
