Emergency Department, Franciscus Gasthuis, Rotterdam, The Netherlands
Emergency Department, Franciscus Gasthuis, Rotterdam, The Netherlands.
BMJ Case Rep. 2023 Jan 3;16(1):e252301. doi: 10.1136/bcr-2022-252301.
Elbow dislocations are commonly seen and can occur after trauma or be congenital. The literature on congenital dislocations is scarce. No cases of an additional luxation of a pre-existing congenital radial head dislocation with a traumatic ulnohumeral dislocation have been described. This case involves a young man with no prior history who presented after trauma of the right elbow. He presented with pain, and his radial head was palpable behind the olecranon, and on imaging it appeared to be more proximal. After additional imaging, the dislocation of the radial head turned out to be congenital combined with an additional luxation of the ulna. This finding influenced our diagnostic approach and reposition method, which, instead of only traction-countertraction, also included pronation and supination.This case highlights the clinical importance of identifying and recognising a patient with a congenital dislocation of the radial head and an additional luxation of the elbow.
肘关节脱位较为常见,可由创伤引起,也可由先天因素所致。先天性肘关节脱位的文献报道较少。目前尚未有文献描述过创伤性尺骨肱骨脱位合并先前存在的先天性桡骨头脱位的额外脱位。本案例涉及一位无既往病史的年轻男性,因右肘创伤就诊。他表现为疼痛,可触及桡骨头位于尺骨鹰嘴后方,影像学检查显示桡骨头更靠近近端。进一步影像学检查显示,桡骨头脱位为先天性,合并尺骨额外脱位。这一发现影响了我们的诊断方法和复位方法,不仅采用了牵引对抗复位,还包括了旋前和旋后。本案例强调了识别和认识桡骨头先天性脱位和肘部额外脱位患者的临床重要性。