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双侧内侧肘突:一例未治疗的伴有骨折块前方嵌顿的内上髁骨折病例报告

Double Medial Elbow Bump: A Case Report of an Untreated Medial Epicondyle Fracture With Anterior Incarceration of the Fragment.

作者信息

Kamat Ajay, Dharmshaktu Ishwar S, Yadav Krishna Dev S, Dharmshaktu Ganesh S

机构信息

Department of Orthopaedics and Trauma, Sindhudurg Shikshan Prasarak Mandal (SSPM) Medical College and Lifetime Hospital, Sindhudurg, IND.

Department of Orthopaedics, Government Medical College Haldwani, Haldwani, IND.

出版信息

Cureus. 2024 Aug 12;16(8):e66686. doi: 10.7759/cureus.66686. eCollection 2024 Aug.

Abstract

Medial epicondyle fractures are uncommon elbow injuries and require careful radiological evaluation for appropriate diagnosis and management. Missed or neglected medial epicondyle fractures, however, are reported as uncommon reports or small series. Incarceration of the medial epicondyle fragment within the elbow joint is often reported and poses therapeutic challenges. Severe displacement of the medial epicondyle fragment and its anterior incarceration within the soft tissues is a rare entity. Here, we report a two-month-old untreated case of an anteriorly displaced medial epicondyle fracture with anterior incarceration, presenting as a clinical bump adjacent to the native medial humeral condyle. This presentation of a double medial bump is uncommon and reported here for its rarity. The injury was finally managed with open reduction internal fixation of the displaced medial epicondyle fragment back to its native site along with the anterior transposition of the ulnar nerve. Good clinical outcome with full elbow range of motion and radiological union was achieved in the follow-up of 13 months.

摘要

肱骨内上髁骨折是一种少见的肘部损伤,需要进行仔细的影像学评估以做出恰当的诊断和处理。然而,漏诊或漏治的肱骨内上髁骨折仅有少量病例报道或小样本研究。肱骨内上髁骨折块卡压于肘关节内的情况常有报道,这给治疗带来了挑战。肱骨内上髁骨折块严重移位并向前卡压于软组织内则较为罕见。在此,我们报告1例2个月大未经治疗的肱骨内上髁骨折向前移位并向前卡压的病例,表现为肱骨内上髁原部位旁的临床肿块。这种双内侧肿块的表现并不常见,因其罕见性在此予以报道。最终通过切开复位将移位的肱骨内上髁骨折块固定回原位,并同时行尺神经前置术对该损伤进行了治疗。在13个月的随访中,患者肘关节活动范围恢复正常,影像学显示骨折愈合,临床效果良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9cd2/11389648/8ee615ae7f1c/cureus-0016-00000066686-i01.jpg

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本文引用的文献

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Medial epicondyle fractures in children.儿童肱骨内上髁骨折
Curr Opin Pediatr. 2015 Feb;27(1):58-66. doi: 10.1097/MOP.0000000000000181.
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Medial epicondyle fractures in the pediatric population.儿童人群中的内上髁骨折。
J Am Acad Orthop Surg. 2012 Apr;20(4):223-32. doi: 10.5435/JAAOS-20-04-223.

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