Elbow Dislocation with Ipsilateral Fracture both Bones Forearm in a Pediatric Age: A Rare Case Report

Volume 6 | Issue 2 | May-August 2020 | Page: 23-26 | Naveen Kumar Singh, Sunny Chaudhary, Nishat Setia, Prateek Girotra

Authors: Naveen Kumar Singh [1], Sunny Chaudhary [2], Nishat Setia [1], Prateek Girotra [1]

[1] Department of Orthopaedics, Hindurao Hospital,Delhi, India.
[2] Department of Orthopaedics, AIIMS Rishikesh, Uttarakhand, India.

Address of Correspondence
Dr. Sunny Chaudhary,
Department of Orthopedics,AIIMS Rishikesh,India
E-mail: dr.sunny.ortho@gmail.com

Abstract

An elbow dislocation with ipsilateral fracture both bones forearm in a pediatric age group is a very rare injury. Although fracture both bones forearm alone in same age group is very common. These injuries in conjunction usually resulted from a high energy trauma and can be missed if clinician is not aware of such injuries so these injuries need to be addressed carefully. Success of functional outcome depends on concentric reduction of dislocated elbow with anatomical restoration of fractured both bones forearm. Here, we report a case of right-sided elbow dislocation with ipsilateral fracture of both bones forearm in a 11-year-old girl. In this case, closed reduction was performed for dislocated elbow in emergency department using reduction maneuver followed by closed reduction of both bones of forearm. Post-reduction neurovascular status of affected limb was checked and found to be uneventful. Active finger movements were present. Patient was followed-up for a period of 1 year. There was good clinical, radiological, and functional outcome. Previously, only two similar cases were reported and the last reported case had an additional finding of fracture lateral humeral condyle. Our case is an elbow dislocation with ipsilateral fracture both bones forearm in the pediatric age group and it was completely managed conservatively which makes our case-report unique in its presentation.
Keywords: Elbow dislocation; Both bone forearm fracture; Paediatric age.

References 

1. Ramesh S, Lim YJ. Complex elbow dislocation associated with radial and ulnar diaphyseal fractures: A rare combination. Strateg Trauma Limb Reconstr 2011;6:97-101.
2. Madhar M, Saidi H, Fikry T, Cermak K, Moungondo F, Schuind F. Dislocation of the elbow with ipsilateral forearm fracture. Six particular cases. Chir Main 2013;32:299-304.
3. Goni V, Behera P, Meena UK, Gopinathan N, Akkina N, Arjun RH. Elbow dislocation with ipsilateral diaphyseal forearm bone fracture: A rare injury report with literature review. Chin J Traumatol 2015;18:113-115.
4. Hung SC, Huang CK, Chiang CC, Chen TH, Chen WM, Lo WH. Monteggia Type I equivalent lesion: Diaphyseal ulna and radius fractures with a posterior elbow dislocation in an adult. Arch Orthop Trauma Surg 2003;123:311-313.
5. Frazier JL, Buschmann WR, Insler HP. Monteggia Type I equivalent lesion: Diaphyseal ulna and proximal radius fracture with a posterior elbow dislocation in a child. J Orthop Trauma 1991;5:373-375.
6. Kose O, Durakbasa MO, Islam NC. Posterolateral elbow dislocation with ipsilateral radial and ulnar diaphyseal fractures: A case report. J Orthop Surg (Hong Kong) 2008;16:122-123.
7. Rijal L, Kc KM, Sagar G. Elbow dislocation with ipsilateral radius and ulna fracture: Is it so common? Nepal Med Coll J 2012;14:163-164.
8. Ring D, Jupiter JB. Fracture-dislocation of the elbow. J Bone Joint Surg Am 1998;80:566-580.
9. Fleming FJ, Flavin R, Poynton AR. Elbow dislocation with ipsilateral open radial and ulnar diaphyseal fractures–a rare combination. Injury 2004;35:90-92.
10. Kumar P, Manjhi LB, Rajak RL. Open segmental fracture of both bone forearm and dislocation of ipsilateral elbow with extruded middle segment radius. Indian J Orthop 2013;47:307-309.
11. Bryce CD, Armstrong AD. Anatomy and biomechanics of the elbow. Orthop Clin North Am 2008;39:141-154.

How to Cite this Article: Singh NK, Chaudhary S, Setia N, Girotra P | Elbow Dislocation with Ipsilateral Fracture both Bones Forearm in a Pediatric Age: A Rare Case Report | International Journal of Paediatric Orthopaedics | May-August 2020; 6(2): 23-26.

(Abstract)      (Full Text HTML)      (Download PDF)

 

 

 

 

 

 

 

 

Posterior Dislocation of Sternoclavicular Joint- A Case Report

Volume 6 | Issue 2 | May-August 2020 | Page: 18-22 | Shikhar Yadav, Renjit John Mathew, Dileep Sasi, John Thayyil John

Authors : Shikhar Yadav [1], Renjit John Mathew [1], Dileep Sasi [1], John Thayyil John [1]

[1] Department of Orthopaedics, Bombay Hospital Institute of Medical Sciences, Mumbai, Maharashtra, India.

Address of Correspondence
Dr. Shikhar Yadav,
Bombay Hospital Institute of Medical Sciences,
Mumbai, Maharashtra, India.
E-mail: dr.shikhar.yadav@gmail.com

Abstract

Background: Traumatic sternoclavicular joint dislocation is a very rare occurrence worldwide and is seen in only 0.5-3% of all injuries to the shoulder girdle . It is seen in high-velocity injuries resulting mostly from road traffic accidents or usually in contact sports such as rugby which is a game not played in our country. The sternoclavicular joint has a lot of important structures belonging to the cardiovascular, nervous, respiratory, and digestive system posterior to it and hence it creates a major challenge to the orthopedic surgeon while dealing with the same. With the lack of incidence and experience on this subject, the surgeon might often miss the diagnosis by not suspecting it or struggle to manage the patient after its diagnosis.
Case Report: A case report of a 12 year old male who has history trauma to the chest which resulted in a posterior dislocation of left sternoclavicular joint and the same was reduced successfully using a closed technique without any complications. A one year follow up of the patient shows complete range of left shoulder with no pain and no history of subsequent instability of the sternoclavicular joint.
Keywords: Posterior dislocation; Sternoclavicular joint; Closed reduction.

References 

1. Groh GI, Wirth MA. Management of traumatic sternoclavicular joint injuries. J Am Acad Orthop Surg 2011;19:1-7.
2. Choo C, Wong H, Nordin A. Traumatic floating clavicle: A case report. Malays Orthop J 2012;6:57-9.
3. Cruz MF, Erdeljac J, Williams R, Brown M, Bolgla L. Posterior sternoclavicular joint dislocation in a division I football player: A case report. Int J Sports Phys Ther 2015;10:700-11.
4. Inman VT, Saunders JB, Abbott LC. Observations of the function of the shoulder joint. 1944. Clin Orthop Relat Res 1996;330:3-12.
5. Spencer EE, Kuhn JE, Huston LJ, Carpenter JE, Hughes RE. Ligamentous restraints to anterior and posterior translation of the sternoclavicular joint. J Shoulder Elbow Surg 2002;11:43-7.
6. Giphart JE, Brunkhorst JP, Horn NH, Shelburne KB, Torry MR, Millett PJ. Effect of plane of arm elevation on glenohumeral kinematics: A normative biplane fluoroscopy study. J Bone Joint Surg Am 2013;95:238-45.
7. Booth CM, Roper BA. Chronic dislocation of the sternoclavicular joint: An operative repair. Clin Orthop Relat Res 1979;140:17-20.
8. Rajaratnam S, Kerins M, Apthorp L. Posterior dislocation of the sternoclavicular joint: A case report and review of the clinical anatomy of the region. Clin Anat 2002;15:108-11.
9. Morell DJ, Thyagarajan DS. Sternoclavicular joint dislocation and its management: A review of the literature. World J Orthop 2016;7:244-50.
10. Howard FM, Shafer SJ. Injuries to the clavicle with neurovascular complications. A study of fourteen cases. J Bone Joint Surg Am 1965;47:1335-46.
11. Jain S, Monbaliu D, Thompson JF. Thoracic outlet syndrome caused by chronic retrosternal dislocation of the clavicle. Successful treatment by transaxillary resection of the first rib. J Bone Joint Surg Br 2002;84:116-8.
12. Nakayama E, Tanaka T, Noguchi T, Yasuda J, Terada Y. Tracheal stenosis caused by retrosternal dislocation of the right clavicle. Ann Thorac Surg 2007;83:685-7.
13. Gardner MA, Bidstrup BP. Intrathoracic great vessel injury resulting from blunt chest trauma associated with posterior dislocation of the sternoclavicular joint. Aust N Z J Surg 1983;53:427-30.
14. Bicos J, Nicholson GP. Treatment and results of sternoclavicular joint injuries. Clin Sports Med 2003;22:359-70.
15. Court-Brown CM, Heckman JD, McQueen MM, Ricci WM, Tornetta P, McKee MD. Rockwood and Green’s Fractures in Adults. Phildelphia, PA: Lippincott Williams and Wilkins; 2015. p. 1623-25.
16. Buckerfield CT, Castle ME. Acute traumatic retrosternal dislocation of the clavicle. J Bone Joint Surg Am 1984;66:379-85.
17. Lehmann W, Laskowski J, Grossterlinden L, Rueger JM. Refixation of sternoclavicular luxation with a suture anchor system. Unfallchirurg 2010;113:418-21.
18. Abiddin Z, Sinopidis C, Grocock CJ, Yin Q, Frostick SP. Suture anchors for treatment of sternoclavicular joint instability. J Shoulder Elbow Surg 2006;15:315-8.
19. Franck WM, Jannasch O, Siassi M, Hennig FF. Balser plate stabilization: An alternate therapy for traumatic sternoclavicular instability. J Shoulder Elbow Surg 2003;12:276-81.
20. Burrows HJ. Tenodesis of subclavius in the treatment of recurrent dislocation of the sterno-clavicular joint. J Bone Joint Surg Br 1951;33B:240-3.
21. Castropil W, Ramadan LB, Bitar AC, Schor B, De Oliveira D’Elia C. Sternoclavicular dislocation–reconstruction with semitendinosus tendon autograft: A case report. Knee Surg Sports Traumatol Arthrosc 2008;16:865-8.
22. Spencer EE, Kuhn JE. Biomechanical analysis of reconstructions for sternoclavicular joint instability. J Bone Joint Surg Am 2004;86:98-105.

How to Cite this Article: Yadav S, Mathew RJ, Sasi D, John JT | Posterior Dislocation of Sternoclavicular Joint- A Case Report | International Journal of Paediatric Orthopaedics | May-August 2020; 6(2): 18-22.

(Abstract)      (Full Text HTML)      (Download PDF)