Ipsilateral distal radius fracture with elbow dislocation-a rare entity: report of 3 cases

  • Authors

    • Ravikumar TV MS Ramaiah Medical College , Bangalore,India
    • Amit Grover MS Ramaiah Medical College , Bangalore,India
    • Daksh Gadi MS Ramaiah Medical College , Bangalore,India
    • Bheemsingh Samorekar MS Ramaiah Medical College , Bangalore,India
    2015-03-03
    https://doi.org/10.14419/ijm.v3i1.4270
  • Combined Injury, Distal Radius Fracture, Elbow Dislocation.
  • Introduction: Elbow joint is the second most common joint to dislocate after shoulder. 20 percent of elbow dislocations are associated with fractures. Elbow dislocations are commonly associated with coronoid process, radial head and olecranon fractures. Dislocations of the elbow commonly accompany proximal ulna or radial fracture. Elbow dislocation with a distal radius fracture is rare. In the literature, there are very few case reports highlighting such an injury.

    We report three cases of ipsilateral closed dislocation at the elbow associated with a closed distal radius fracture presented to us over a period of three years. Elbow dislocation was managed by closed reduction in two cases, and k wiring was required in one case. For distal radius open reduction and internal fixation by a buttress plate was done for two cases, and one was managed conservatively. At 6 months of follow up patients had full range of movement of the elbow joint and complete union of the distal radius fracture.

    Therefore, clinical and radiological assessment of one joint above and below should be done in every case so that these injuries, although rare, should not be missed. In a case of elbow dislocation, a possibility of a distal radius fracture should be kept in mind. A very high degree of suspicion is required for such cases.

  • References

    1. [1] Royle SG. Posterior dislocation of the elbow.ClinOrthop 1991 269 : 201-204

      [2] Jungbluth P, Hakimi M, Linhart W, Windolf J. Current Concepts: Simple and Complex Elbow Dislocations – Acute and Definitive Treatment. European Journal of Trauma and Emergency Surgery 2008; 34(2):120-30 http://dx.doi.org/10.1007/s00068-008-8033-9.

      [3] Hildebrand KA, Patterson SD, King GJ. Acute elbow dislocations: simple and complex. Orthop Clin North Am. 1999 Jan; 30(1):63-79. http://dx.doi.org/10.1016/S0030-5898(05)70061-4.

      [4] Broberg MA, Morrey BF. Results of treatment of fracture dislocations of the elbow. Clin Orthop Relat Res. 1987 Mar ;( 216):109-19.

      [5] McKee MD, Bowden SH, King GJ, Patterson SD, Jupiter JB,Bamberger HB, Paksima N. Management of recurrent, complex instability of the elbow with a hinged external fixator. J Bone Joint Surg Br. 1998 Nov; 80(6):1031-6. http://dx.doi.org/10.1302/0301-620X.80B6.8536.

      [6] Ring D, Jupiter JB. Fracture-dislocation of the elbow. J Bone Joint Surg Am. 1998; 80:566–80.

      [7] Batra S, Andrew JG. Ipsilateral compound distal radius fracture with missed elbow dislocation. A rare injury pattern. Eur J Emerg Med. 2007; 14:363–4 http://dx.doi.org/10.1097/MEJ.0b013e32823a3cad.

      [8] Ahmad R, Ahmed SM, Annamalai S, Case R. Open dislocation of the elbow with ipsilateral fracture of the radial head and distal radius: A rare combination without vascular injury. Emerg Med J. 2007; 24:860. http://dx.doi.org/10.1136/emj.2006.044016.

      [9] Nanno M, Sawaizumi T, Ito H. Transverse divergent dislocation of the elbow with ipsilateral distal radius fracture in a child. J Orthop Trauma. 2007; 21:145–9 http://dx.doi.org/10.1097/BOT.0b013e318032c4be.

      [10] Frykman GK. Fractures of the distal radius including sequelae-shoulder-hand-finger syndrome, disturbance in the distal radio-ulnar joint and impairment of nerve function. Acta Orthop Scand 1967 ;( Suppl 108):7-153.

      [11] Hotchkiss RN. Fractures and dislocations of the elbow. In: Rockwood CA, Green DP, Heckman RW, Bucholz JD, editors. Rockwood and Green's fractures in adults. Philadelphia: Lippincott Williams and Wilkins; 1966. pp. 980–1.

      [12] Bado JL. The Monteggia lesion. Clin Orthop Relat Res. 1967; 50:71–86. http://dx.doi.org/10.1097/00003086-196701000-00008.

      [13] Hung SC, Huang CK, Chiang CC, Chen TH, Chen WM, Lo WH. Monteggia type 1 equivalent lesion: Diaphyseal ulna and radius fractures with a posterior elbow dislocation in an adult. Arch Orthop Trauma Surg. 2003; 123:311–3. http://dx.doi.org/10.1007/s00402-003-0526-8.

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    TV, R., Grover, A., Gadi, D., & Samorekar, B. (2015). Ipsilateral distal radius fracture with elbow dislocation-a rare entity: report of 3 cases. International Journal of Medicine, 3(1), 12-15. https://doi.org/10.14419/ijm.v3i1.4270