Ipsilateral proximal and distal radius fractures with unstable elbow joint: Which should we address first?
10.1016/j.cjtee.2018.04.007
- Author:
Nur Azuatul AKMA KAMALUDIN
1
;
Nur Azree FERDAUS KAMUDIN
2
,
3
;
Shalimar ABDULLAH
1
;
Jamari SAPUAN
1
Author Information
1. Department of Orthopaedics & Traumatology, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia.
2. Department of Orthopaedics & Traumatology, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
3. Faculty of Medicine, Universiti Sultan Zainal Abidin, Kuala Terengganu, Terengganu, Malaysia. Electronic address: n.azree.kamudin@gmail.com.
- Publication Type:Case Reports
- Keywords:
Irreducible elbow dislocation;
Radial head;
Radial head arthroplasty;
Radius fractures;
Simultaneous ipsilateral fractures
- MeSH:
Accidental Falls;
Aged;
Arthroplasty, Replacement;
methods;
Elbow Joint;
Female;
Fracture Fixation, Internal;
Humans;
Joint Instability;
Magnetic Resonance Imaging;
Open Fracture Reduction;
Radius;
diagnostic imaging;
surgery;
Radius Fractures;
diagnostic imaging;
surgery;
Treatment Outcome
- From:
Chinese Journal of Traumatology
2019;22(1):59-62
- CountryChina
- Language:English
-
Abstract:
Simultaneous ipsilateral fractures involving radial head and distal end of radius are uncommon. We present our thoughts on which fracture should be addressed first. A 68-year-old lady sustained an ipsilateral fracture of the right radial head and distal end of radius following a fall. Clinically her right elbow was posteriorly dislocated and right wrist was deformed. Plain radiographs showed an intraarticular fracture of the distal end of radius and a comminution radial head fracture with a proximally migrated radius. Magnetic resonance imaging (MRI) showed no significant ligament injuries. We addressed her distal radius first with an anatomical locking plate followed by her radial head with a radial head replacement. Our rationale to treat the distal end radius: first was to obtain a correct alignment of Lister's tubercle and correct the distal radius height. Lister's tubercle was used to guide for the correct rotation of the radial head prosthesis. Correcting the distal end fracture radial height helped us with length selection of the radial head prosthesis and address the proximally migrated radial shaft and neck. Postoperative radiographs showed an acceptable reduction. The Cooney score was 75 at 3 months postoperatively, which was equivalent to a fair functional outcome.
