Huang Guo-Hua, Tang Jiang-An, Yang Tie-Yi, Liu Yue
Department of Orthopedics, Shanghai Pudong New Area Gongli Hospital, Affiliated to the Second Military Medical University, Shanghai 200135, China.
World J Clin Cases. 2021 May 16;9(14):3372-3378. doi: 10.12998/wjcc.v9.i14.3372.
Floating elbow along with ipsilateral multiple segmental forearm fracture is a rare and high-energy injury, although elbow dislocation or fracture of the ulna and radius may occur separately.
We report the case of a 37-year-old woman with open (IIIA) fracture of the right distal humerus with multiple shaft fractures of the ipsilateral radius and ulna with a history of falling from a height of almost 20 m from a balcony. After providing advanced trauma life support, damage control surgery was performed to debride the arm wound and temporarily stabilize the right upper limb with external fixators in the emergency operating room. Subsequently, one-stage internal fixation of multiple fractures was performed with normal values of biochemical indicators and reduction in limb swelling. The patient achieved good outcome at the 7 mo follow-up.
One- or two-stage treatment must be performed according to the type of injury; we efficiently used the "damage control principle."
漂浮肘合并同侧多节段前臂骨折是一种罕见的高能量损伤，尽管肘关节脱位或尺桡骨骨折可能单独发生。
我们报告一例37岁女性患者，因从阳台约20米高处坠落致右侧肱骨远端开放性（IIIA型）骨折，同侧桡骨和尺骨多段骨干骨折。在进行高级创伤生命支持后，于急诊手术室行损伤控制手术，清创手臂伤口，并用外固定架临时固定右上肢。随后，在生化指标正常且肢体肿胀减轻后，对多处骨折进行一期内固定。患者在7个月随访时获得良好预后。
必须根据损伤类型进行一期或二期治疗；我们有效地运用了“损伤控制原则”。
