Ginting Florensius, Chilmi Mohammad Zaim
Department of Orthopedics and Traumatology, Faculty of Medicine, Universitas Airlangga, East Java, Surabaya, Indonesia; Department Orthopedics and Traumatology, Dr. Soetomo General Academic Hospital, East Java, Surabaya, Indonesia.
Department of Orthopedics and Traumatology, Faculty of Medicine, Universitas Airlangga, East Java, Surabaya, Indonesia; Department Orthopedics and Traumatology, Dr. Soetomo General Academic Hospital, East Java, Surabaya, Indonesia.
Int J Surg Case Rep. 2025 Feb;127:110777. doi: 10.1016/j.ijscr.2024.110777. Epub 2024 Dec 26.
Multifocal fractures in a single upper extremity represent a significant clinical challenge, often resulting from high-energy impacts such as motor vehicle accidents or severe falls. These injuries require complex, multifaceted approaches in management, spanning initial acute care to long-term rehabilitation. This paper examines the complexities of diagnosing, treating, and rehabilitating multifocal upper extremity fractures, highlighting the importance of timely intervention and a multidisciplinary approach to maximize functional recovery, minimize long-term disability and the prognosis.
A 25-year-old male was admitted to the emergency department after being struck by a vehicle, sustaining multiple fractures in his right upper extremity, including the scapula, proximal humerus, radius, and ulna. Initial management involved stabilizing the fractures with external fixation and performing a craniotomy for an associated epidural hematoma. After stabilization, definitive surgical repairs were performed, including ORIF for the humerus and radius ulna, followed by rehabilitation to address functional deficits.
The management of multiple fractures in a single upper extremity requires timely surgical interventions, such as ORIF, to stabilize complex fracture patterns. Effective postoperative rehabilitation is essential for recovery and depends heavily on patient compliance and comprehensive care. Although advances in surgical techniques have improved outcomes, challenges remain in reducing soft tissue damage and preventing long-term complications like joint stiffness and chronic pain.
Multiple fractures in a single upper extremity usually result from high-energy trauma, necessitating comprehensive management strategies.
单一上肢的多灶性骨折是一项重大的临床挑战，通常由诸如机动车事故或严重跌倒等高能量冲击导致。这些损伤在处理上需要复杂、多方面的方法，涵盖从初始的急性护理到长期康复。本文探讨了诊断、治疗和康复单一上肢多灶性骨折的复杂性，强调了及时干预和多学科方法对于最大化功能恢复、最小化长期残疾及改善预后的重要性。
一名25岁男性在被车辆撞击后被送往急诊科，其右上肢多处骨折，包括肩胛骨、肱骨近端、桡骨和尺骨。初始处理包括用外固定稳定骨折，并对相关的硬膜外血肿进行开颅手术。稳定后，进行了确定性手术修复，包括对肱骨和尺桡骨进行切开复位内固定，随后进行康复以解决功能缺陷。
单一上肢多处骨折的处理需要及时的手术干预，如切开复位内固定，以稳定复杂的骨折模式。有效的术后康复对于恢复至关重要，并且在很大程度上取决于患者的依从性和全面护理。尽管手术技术的进步改善了治疗结果，但在减少软组织损伤和预防诸如关节僵硬和慢性疼痛等长期并发症方面仍存在挑战。
单一上肢的多处骨折通常由高能量创伤导致，需要综合管理策略。
