Samara Eleftheria, Dayer Romain, Davat Marie, Ruffieux Etienne, Steiger Christina N, Ceroni Dimitri
Pediatric Orthopaedic Department, Geneva University Hospitals, Geneva, Switzerland.
JBJS Case Connect. 2020 Jan-Mar;10(1):e0445. doi: 10.2106/JBJS.CC.18.00445.
A 14-year-old girl sustained a posterior elbow dislocation and presented with a proximal radioulnar translocation (PRUT) and a displaced fracture of the radial head. Reduction of the elbow dislocation and the proximal radioulnar translocation were achieved by external manipulation in the operating room. The radial head was not amenable to closed reduction and remained entrapped in the anteromedial compartment of the elbow. So open reduction and internal stabilization was carried out.
In PRUT, closed reduction should be attempted. The radial head should be preserved even if it is fully dislocated from metaphysis. Retrograde intramedullary radial nailing provides enough stability of the fracture to promote early mobilization and facilitate union.
一名14岁女孩发生肘关节后脱位，伴有近端桡尺关节移位（PRUT）及桡骨头骨折并移位。在手术室通过手法复位实现了肘关节脱位及近端桡尺关节移位的复位。桡骨头无法通过闭合复位，仍嵌顿于肘关节的前内侧间隙。因此进行了切开复位内固定。
对于近端桡尺关节移位，应尝试闭合复位。即使桡骨头与干骺端完全脱位，也应予以保留。逆行髓内桡骨钉固定可为骨折提供足够的稳定性，以促进早期活动并利于骨折愈合。
