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一例小儿漂浮肘合并屈曲型肱骨髁上骨折、双骨折前臂骨折及尺神经刺激:病例报告

A Pediatric Floating Elbow Associating Flexion Type Supracondylar Fracture with Both Bone Forearm Fracture And Ulnar Nerve Irritation: A Case Report.

作者信息

Moussa Mohamad K, Semaan Doumit

机构信息

Department of Orthopaedics, Geitawi Lebanese Hospital, University Medical Center, Beirut - Lebanon.

出版信息

J Orthop Case Rep. 2020 Dec;10(9):71-74. doi: 10.13107/jocr.2020.v10.i09.1908.

Abstract

INTRODUCTION

Pediatric floating elbow in the setting of flexion type-supracondylar fracture is exceptional. Most reported cases in the literature include the more common variant of supracondylar fracture which is the extension type. We report a rare case of pediatric floating elbow associating flexion type supracondylar fracture with both bone forearm fracture and ulnar nerve irritation.

CASE REPORT

A 5-year-old boy presenting to the emergency department after sustaining a fall from 3 m height. At presentation, he had an S-shaped deformity of the left upper limb, along with ecchymosis of the medial side of the elbow and the anterior aspect of the forearm. He was also complaining of severe pain with numbness in the territories of the ulnar nerve at the level of the wrist and hand without any signs of the median nerve or radial nerve neuropraxia or injury. The primary assessment demonstrated left flexion type supracondylar fracture, along with ipsilateral radial shaft fracture and ulnar shaft fracture. The patient was treated surgically by open reduction internal fixation of the supracondylar fracture followed by closed reduction and fixation of both bone forearm fracture.

CONCLUSION

This case is reported for the unique association of flexion type supracondylar fracture - a rare type of supracondylar fracture in children - with ipsilateral both bone forearm fracture in a setting of the floating elbow and a relatively low incident complication which is ulnar nerve neuropraxia.

摘要

引言

小儿屈曲型肱骨髁上骨折合并漂浮肘的情况极为罕见。文献中报道的大多数病例为肱骨髁上骨折更常见的类型,即伸展型。我们报告了一例罕见的小儿漂浮肘病例,该病例为屈曲型肱骨髁上骨折合并双骨折前臂骨折及尺神经刺激。

病例报告

一名5岁男孩从3米高处坠落后来到急诊科。就诊时,他的左上肢呈S形畸形,肘部内侧和前臂前方有瘀斑。他还抱怨手腕和手部尺神经支配区域剧痛伴麻木,无正中神经或桡神经神经失用或损伤的任何体征。初步评估显示为左屈曲型肱骨髁上骨折,同时伴有同侧桡骨干骨折和尺骨干骨折。患者接受了手术治疗,先对肱骨髁上骨折进行切开复位内固定,随后对双骨折前臂骨折进行闭合复位和固定。

结论

本病例报告了屈曲型肱骨髁上骨折(一种儿童罕见的肱骨髁上骨折类型)与同侧双骨折前臂骨折在漂浮肘情况下的独特关联,以及相对低发生率的并发症——尺神经神经失用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2da6/8046451/91966718852d/JOCR-10-71-g001.jpg

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