Masionis Povilas, Bobina Rokas, Uvarovas Valentinas, Porvaneckas Narūnas, Šatkauskas Igoris
Centre of Orthopaedics and Traumatology, Vilnius University Hospital Santaros Klinikos, Faculty of Medicine, Vilnius University, Clinic of Rheumatology, Orthopaedics-Traumatology, and Reconstructive Surgery, Vilnius, Lithuania.
Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
Acta Med Litu. 2019;26(3):167-172. doi: 10.6001/actamedica.v26i3.4146.
Dislocation of the elbow joint is the second most common dislocation after the shoulder joint. Although this pathology is relatively common, concomitant vascular injuries are rare. We present a case of a patient who sustained a fall on his arm with an outstretched elbow that resulted in a closed simple posterolateral elbow dislocation and delayed thrombosis of the brachial artery followed by two revascularisation surgeries. The physician must always maintain a high index of suspicion for a concomitant vascular injury before and after closed reduction of the elbow joint and have in mind that complete ischemia without any pulsations could be absent because the elbow is surrounded by rich collateral anastomoses. Suspicion should be even stronger in the presence of bony lesions or open injuries. A team of trauma and vascular surgeons has to work hand in hand as surgical treatment with a saphenous graft or direct suture is the first method of choice with the prior requirement of a stable elbow joint.
肘关节脱位是仅次于肩关节脱位的第二常见脱位。尽管这种病理情况相对常见，但合并血管损伤却很罕见。我们报告一例患者，其伸直肘部时手臂着地，导致闭合性单纯后外侧肘关节脱位，肱动脉延迟血栓形成，随后进行了两次血管重建手术。在肘关节闭合复位前后，医生必须始终对合并血管损伤保持高度怀疑，并且要记住，由于肘部周围有丰富的侧支吻合，可能不存在完全缺血且无任何搏动的情况。在存在骨损伤或开放性损伤时，怀疑应更强。创伤和血管外科团队必须携手合作，因为采用隐静脉移植或直接缝合的手术治疗是首选方法，前提是肘关节要稳定。
