scholarly journals Complex open elbow fracture-dislocation with severe proximal ulna bone loss: a case report of massive osteochondral allograft surgical treatment

2021 ◽  
Author(s):  
Chiara Concina ◽  
Marina Crucil ◽  
Emmanouil Theodorakis ◽  
Giorgio Saggin ◽  
Silvia Perin ◽  
...  
Keyword(s):  
Bone Loss ◽  
Shaft Fracture ◽  
Fracture Dislocation ◽  
Osteochondral Allograft ◽  
Proper Solution ◽  
Elbow Fracture ◽  
Dash Score ◽  
Proximal Ulna ◽  
Wound Debridement ◽  
Superficial Wound

We report a case of a 69-year-old right-dominant man who had an open Monteggia-like lesion of the right elbow (Gustilo-Andersen IIIA) with severe proximal ulna bone loss associated with an ipsilateral ulnar shaft fracture due to a motorcycle accident. The patient underwent two-stage surgery. Wound debridement and bridging external fixation were performed at first. Three months later, a frozen massive osteochondral ulnar allograft was implanted and fixed with a locking compression plate. A superficial wound infection appeared 5 weeks after the second surgery. Superficial wound debridement, negative pressure therapy, and antibiotics were administered for 3 months, achieving infection healing. At 3 years post-surgery, the elbow range of motion was satisfactory with a Disabilities of the Arm, Shoulder and Hand (DASH) score of 16.7. Radiographs and computed tomography scans showed good allograft-bone integration without allograft reabsorption or hardware loosening. Although not complication-free, massive ulna osteochondral allograft implantation can be considered a valid option in cases of open Monteggia-like lesions associated with ulnar shaft fracture and severe bone loss in active patients, whenever osteosynthesis or joint replacement is not a proper solution. This type of bone stock restoration allows for future surgery, like arthroplasty, if needed.

Terrible Triad Elbow Fracture Dislocation with Ipsilateral Triceps Avulsion and Radial Shaft Fracture

2020 ◽  
Vol 10 (4) ◽  
pp. e20.00308-e20.00308
Author(s):  
HamidReza Dehghani Nazhvani ◽  
Sam Bemani Lirgeshasi ◽  
Milad Bahari
Keyword(s):  
Shaft Fracture ◽  
Fracture Dislocation ◽  
Elbow Fracture ◽  
Terrible Triad ◽  
Elbow Fracture Dislocation

scholarly journals Transcapsular Buttonholing of the Proximal Ulna as a Cause for Irreducible Pediatric Anterior Elbow Dislocation

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Nick N. Patel ◽  
Robert W. Bruce
Keyword(s):  
Closed Reduction ◽  
Pediatric Population ◽  
Elbow Dislocation ◽  
Joint Capsule ◽  
Fracture Dislocation ◽  
Elbow Fracture ◽  
Proximal Ulna ◽  
Elbow Fracture Dislocation ◽  
Olecranon Fractures ◽  
Insight Into

Anterior elbow dislocations in the pediatric population represent rare and sometimes difficult injuries to manage. Associated olecranon fractures are even more uncommon with limited literature existing on the topic. We present the case of a six-year-old male with a traumatic transolecranon anterior elbow fracture dislocation in whom closed reduction was prevented by buttonholing of the proximal ulna through the anterior joint capsule. This case of pediatric anterior elbow fracture dislocation provides insight into an uncommon and challenging injury complex.

scholarly journals Open anterolateral fracture dislocation of ankle joint: a rare case report

2018 ◽  
Vol 5 (1) ◽  
pp. 192
Author(s):  
Prasanna Anaberu ◽  
R. Prathik ◽  
R. Manish
Keyword(s):  
Ankle Joint ◽  
Fracture Fixation ◽  
Road Traffic ◽  
Emergency Operation ◽  
High Energy ◽  
Fracture Dislocation ◽  
Anterior Dislocation ◽  
Malleolar Fracture ◽  
Rare Injury ◽  
Wound Debridement

<p class="abstract">Anterior ankle dislocation with associated compound bi-malleolar fracture is a rare injury. Ankle fracture dislocations most frequently occurs in young males caused by high energy trauma. The direction of the joint dislocation is determined by the position of the foot and the direction of the force being applied. A middle aged male presented to us with history of road traffic accident and was diagnosed to have anterior dislocation of right ankle joint with compound bi-malleolar fracture. Patient was taken to emergency operation theatre for wound debridement and immediate ankle reduction done under sedation. Due to wound contamination fracture fixation was delayed, once the wound healed bi-malleolar fracture fixation was done.</p>

Elbow Fracture Dislocation

2018 ◽  
pp. 127-138
Author(s):  
Chad M. Corrigan ◽  
Clay A. Spitler ◽  
Basem Attum
Keyword(s):  
Fracture Dislocation ◽  
Elbow Fracture ◽  
Elbow Fracture Dislocation

Treatment of Infected Bone loss with External Fixator in Long Bone Shaft Fracture

1994 ◽  
Vol 29 (6) ◽  
pp. 1621
Author(s):  
Seung Rim Park ◽  
Hyoung Soo Kim ◽  
Kyoung Ho Moon ◽  
Joon Soon Kang ◽  
Hong Sub Lee
Keyword(s):  
Bone Loss ◽  
External Fixator ◽  
Shaft Fracture ◽  
Long Bone

scholarly journals Elbow Dislocation with Ipsilateral Radial Shaft Fracture – A Case Report

2019 ◽  
Vol 47 (02) ◽  
pp. 131-136
Author(s):  
Marcio Aurelio Aita ◽  
Ricardo Kaempf de Oliveira ◽  
Rafael Pêgas Praetzel ◽  
Fernando Towata ◽  
Pedro Jose Delgado ◽  
...  
Keyword(s):  
Case Report ◽  
Early Recognition ◽  
Case Reports ◽  
Elbow Dislocation ◽  
Shaft Fracture ◽  
Clinical Results ◽  
Urgent Care ◽  
Dash Score ◽  
Radial Fracture ◽  
Palmar Approach

Background Posterior dislocation of the elbow associated to a radial shaft fracture is a rare lesion, its treatment is difficult and complicated, and the indications, surgical options, and timing of surgery may vary. In the present case, we performed immediately after the trauma (urgent care) an open reduction internal fixation (ORIF) surgery of the radial fracture by means of a 3.5 mm locking plate, associated to closed elbow reduction and stabilization with dynamic bracing. Case Report A 26-year-old woman was seen in our service with a traumatic deformity of her right, dominant forearm and elbow after a fall from a balance board and presented with a radial shaft fracture and posterior elbow dislocation. The palmar approach was used and the shaft fracture was fixated. During the radial fracture reduction maneuver, the dislocation of the elbow was spontaneously reduced. At 1 year postoperatively, the patient showed good wrist, forearm, and elbow range of motion (ROM). Disabilities of the arm, shoulder and hand (DASH) score of 5, visual analogue scale (VAS) of 0, and grip strength of 92%, as compared with the nonaffected side. Clinical Relevance Nowadays, case reports of concomitant, ipsilateral multiple injuries that uncommonly occur together in a single traumatic episode are very rare. The awareness of this association for early recognition is of paramount significance for ideal clinical results.

Elbow Dislocation and Articular Fracture of the Distal Humerus

2010 ◽  
Vol 2 (2) ◽  
pp. 111-117 ◽  
Author(s):  
Thierry G. Guitton ◽  
Andrew D. Duckworth ◽  
Margaret M. Mcqueen ◽  
Peter Kloen ◽  
David Ring
Keyword(s):  
Medial Collateral Ligament ◽  
Articular Surface ◽  
Present Report ◽  
Elbow Dislocation ◽  
Distal Humerus ◽  
Fracture Dislocation ◽  
Elbow Fracture ◽  
Collateral Ligament ◽  
Articular Fracture

Background The present report describes subluxation and dislocation of the elbow with articular fracture of the distal humerus and injury to the medial collateral ligament, a type of elbow fracture-dislocation about which little is available in the literature. Methods Twenty-two patients with subluxation or dislocation of the elbow (with injury to the medial collateral ligament) and a fracture of the distal humerus articular surface (capitellum/trochlea) were identified. Seventeen patients had a minimum of 12 months follow-up and eight patients returned for a long-term follow-up at a median of 36 months (range 12 months to 154 months) after injury. Results Nine patients had one or more subsequent surgeries. Seven patients had surgery to address complications and two had a planned implant removal. The final median arc of elbow flexion was 120° (range 100° to 145°) and the median arc of forearm rotation was 175° (range 150° to 180°). The median Broberg and Morrey score was 88 points (range 63 points to 100 points) and the median Disabilities of the Arm Shoulder and Hand score was 9 points (range 1 point to 43 points). Discussion Some elbow dislocations and subluxations are associated with osteochondral fractures of the distal humeral articular surface.

A structured exercise programme combined with proprioceptive neuromuscular facilitation stretching or static stretching in posttraumatic stiffness of the elbow: a randomized controlled trial

2018 ◽  
Vol 33 (2) ◽  
pp. 241-252 ◽  
Author(s):  
Tansu Birinci ◽  
Arzu Razak Ozdincler ◽  
Suleyman Altun ◽  
Cemal Kural
Keyword(s):  
Elbow Flexion ◽  
Exercise Programme ◽  
Analysis Of Covariance ◽  
Global Rating ◽  
Elbow Fracture ◽  
Dash Score ◽  
Static Stretching ◽  
Elbow Stiffness ◽  
Randomized Controlled ◽  
Proprioceptive Neuromuscular Facilitation

Objectives: To compare the different stretching techniques, proprioceptive neuromuscular facilitation (PNF) stretching and static stretching, in patients with elbow stiffness after a treated elbow fracture. Design: Randomized-controlled, single-blind study. Setting: Department of physiotherapy and rehabilitation. Subjects: Forty patients with posttraumatic elbow stiffness (24 women; mean age, 41.34 ± 7.57 years). Intervention: PNF stretching group ( n = 20), hold-relax PNF stretching combined with a structured exercise programme (two days per week for six weeks); static stretching group ( n = 20), static stretching combined with a structured exercise programme (two days per week for six weeks). Main measures: The primary outcome is the Disabilities of the Arm, Shoulder and Hand (DASH). The secondary outcomes are active range of motion (AROM), visual analogue scale (VAS), Tampa Scale for Kinesiophobia, Short Form-12 and Global Rating of Change. Participants were assessed at baseline, after a six-week intervention period and one-month later (follow-up). Results: After treatment, improvement in the mean DASH score was slightly better in the PNF stretching group (8.66 ± 6.15) compared with the static stretching group (19.25 ± 10.30) ( p = 0.03). The overall group-by-time interaction for the 2 × 3 mixed-model analysis of covariance (ANCOVA) was also significant for elbow flexion AROM (mean change for PNF stretching group; static stretching group; 41.10, 34.42, p = 0.04), VAS-rest (–1.31, –1.08, p = 0.03) and VAS-activity (–3.78, –3.47, p = 0.01) in favour of PNF stretching group. The other outcomes did not differ significantly between the two groups. Conclusion: The study demonstrated that the structured exercise programme combined with PNF stretching might be effective in patients with posttraumatic elbow stiffness with regard to improving function, elbow flexion AROM, pain at rest and during activity.

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