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创伤性肱骨头前骨折脱位。一例罕见病例报告。

Traumatic anterior fracture dislocation of the humeral head. A rare case report.

作者信息

Kondo Tumwesige R, Mapunda Michael, Mwanga Tangai, Mrimba Peter Magembe, Temu Rogers J, Kawiche Godlisten S

机构信息

Department of Orthopedics and Traumatology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania; Kilimanjaro Christian Medical University College, Moshi, Tanzania.

Department of Orthopedics and Traumatology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania; Kilimanjaro Christian Medical University College, Moshi, Tanzania.

出版信息

Int J Surg Case Rep. 2024 Nov;124:110469. doi: 10.1016/j.ijscr.2024.110469. Epub 2024 Oct 17.

Abstract

INTRODUCTION

Anterior fracture dislocation of the humerus with an anatomical neck fracture is an uncommon injury. These injuries pose a significant risk of devastating complications, such as avascular necrosis of the humeral head, due to the poor vascularization of the area, and stiffness resulting from prolonged immobilization.

CLINICAL PRESENTATION

We report a case of a 20-year-old female who was involved in a motor vehicle crash and sustained an anterior fracture dislocation of the humerus with an anatomical neck fracture. The injury was successfully managed with open reduction and internal fixation using a plate and screws. Given the rarity of this type of injury, this case provides valuable insights into its management and prognosis.

DISCUSSION

Proximal humeral fractures are common injuries, although fractures at the level of the anatomical neck are less common in orthopedic traumatology. The management of these injuries is guided by factors such as fracture morphology, displacement, potential disruption to blood supply, bone quality, patient's age, and functional demands. Various surgical management strategies have been proposed, emphasizing early intervention to minimize the risk of complications.

CONCLUSION

This case aims to highlight the importance of the value of early operative intervention, good anatomic reduction with stable fixation, and the importance of early mobilization of the shoulder to achieve favorable outcomes and minimize complications such as stiffness in patients with this type of injury.

摘要

引言

肱骨解剖颈骨折合并前方骨折脱位是一种罕见的损伤。由于该区域血运较差,此类损伤会带来诸如肱骨头缺血性坏死等严重并发症的重大风险,以及因长期固定导致的僵硬。

临床表现

我们报告一例20岁女性,她在机动车事故中发生肱骨解剖颈骨折合并前方骨折脱位。通过使用钢板和螺钉进行切开复位内固定,该损伤得到成功处理。鉴于此类损伤的罕见性,本病例为其治疗和预后提供了有价值的见解。

讨论

肱骨近端骨折是常见损伤,尽管在骨科创伤中解剖颈水平的骨折不太常见。这些损伤的治疗受骨折形态、移位、对血供的潜在破坏、骨质、患者年龄和功能需求等因素指导。已提出各种手术治疗策略,强调早期干预以将并发症风险降至最低。

结论

本病例旨在强调早期手术干预的价值、良好解剖复位及稳定固定的重要性,以及早期活动肩关节对于实现良好预后并将此类损伤患者的僵硬等并发症降至最低的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f467/11532452/e464f27adf99/gr1.jpg

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