Biepicondylar fracture dislocation of the elbow joint concomitant with ulnar nerve injury

Abstract

In this article, we present a case of humeral biepicondylar fracture dislocation concomitant with ulnar nerve injury in a seventeen year-old male patient. Physical examination of our patient in the emergency room revealed a painful, edematous and deformed-looking left elbow joint. Hypoesthesia of the little finger was also diagnosed on the left hand. Radiological assessment ended up with a posterior fracture dislocation of the elbow joint accompanied by intra-articular loose bodies. Open reduction-Internal fixation of the fracture dislocation and ulnar nerve exploration were performed under general anesthesia at the same session as surgical treatment of our patient. Physical therapy and rehabilitation protocol was implemented at the end of two weeks post-operatively. Union of the fracture lines, as well as the olecranon osteotomy site, was achieved at the end of four months post-operatively. Ulnar nerve function was fully restored without any sensory or motor loss. Range of motion at the elbow joint was 20-120 degrees at the latest follow-up.© 2013 Baishideng. All rights reserved. Key words: Elbow injury; Fracture dislocation; Biepiconylar humeral fracture; Ulnar nerve injuryCore tip: Elbow joint posterior fracture-dislocations accompanied by neurovascular injuries are generally require surgical intervention. In this article, we present a case of humeral biepicondylar fracture dislocation concomitant with ulnar nerve injury in a seventeen yearold male patient. We obtained a successful clinical result by applying open reduction-internal fixation of the fracture dislocation and ulnar nerve repair at the same session as surgical treatment of this case. Although elbow fracture-dislocations with neurovascular complications are rarely seen, assessment of the neurovascular status in emergency room should always be a crucial part of physical examination which may affect the clinical result of the treatment.

Pure elbow dislocation in the paediatric age group

“…Dislocations of the elbow have been reported as often accompanied by disruption of multiple stabilisers, and thus the patho-physiology is complicated [15]. Traumatic elbow dislocation is uncommon in skeletally immature patients and generally diagnosed with concomitant fractures, avulsions or neurovascular injuries around the joint [1,5,6,[12][13][14][15][16][17][18][19].…”

Biepicondylar Fracture of the Humerus in an Adult Female: A Case Report

“…All of these cases reported children and, as far as we could reach, we did not find any case that involved adults in the medical literature. [2][3][4][5][6][7] Although the mechanism of this injury has not been clearly elucidated, the following can be assumed. Medial epicondyle fracture is commonly caused by a valgus stress producing traction on the medial epicondyle through the flexor-pronator tendon.…”

“…To the best of our knowledge, there have been only six cases reporting humeral biepicondylar fracture and its treatment in children. [2][3][4][5][6][7] However, it has never been reported in adults. Herein, we present a case of humeral biepicondylar fracture in a 65-year-old female patient.…”

Complex Elbow Dislocations and the “Terrible Triad” Injury

“…These injuries were associated with high energy mechanisms. A variant of the posterior dislocation has been described with biepicondylar humeral fracture in a seventeen year old male patient [ 63 ], and also with radial shaft fracture and radial head dislocation [ 64 ]. This highlights the need of the surgeon to thoroughly assess the patient with routine examination of structures around the elbow that are not usually associated with complex dislocation.…”