39-217
Luxación posterior de codo asociada a traslocación radiocubital proximal
Elbow dislocation with proximal radioulnar translocation
J. GASCÓ GÓMEZ*, F. GOMAR SANCHO*, J. GASCÓ ADRIÉN** * HOSPITAL CLÍNICO UNIVERSITARIO. SERVICIO DE CIRUGÍA ORTOPÉDICA Y TRAUMATOLOGÍA. DEPARTAMENTO DE CIRUGÍA. FACULTAD DE MEDICINA DE VALENCIA. ** HOSPITAL SON DURETA. SERVICIO DE CIRUGÍA ORTOPÉDICA Y TRAUMATOLOGÍA. PALMA DE MALLORCA
Recepción:
15/09/2008
Aceptación:
15/09/2008
Publicación:
15/09/2008
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Resumen (ES)
Isolated elbow dislocations are uncommon in children,
and usually they present associated to elbow fractures.
Elbow dislocation with proximal radioulnar translocation is
exceptional, and only nine cases had been reported. It was
first described by MacSween in 1978. We present a nine
years old boy who presented this rare lesion secondary to
casual fall. Typical mechanism of injury consists of falling
over the forearm in forced pronation, as it occurred in our
case here presented. Another mechanism described though
very uncommon is the iatrogenic presentation, when trying
reduction manoeuvres with the forearm in pronated position.
Initial diagnosis may be difficult due to the apparent good
reduction of the posterior dislocation, but radioulnar translocation
persists and can be neglected as in our case. Here
appropriate examination tests are described to avoid this
condition. Treatment by close manipulation usually leads to
poor results, and that is why open reduction is often advisable.
We recommend the lateral approach, with radial release
and annular ligament reconstruction. Associated fractures
and other complications are frequent. In this case we had
heterotopic ossifications that limited prono-supination range
of motion to 100º.
and usually they present associated to elbow fractures.
Elbow dislocation with proximal radioulnar translocation is
exceptional, and only nine cases had been reported. It was
first described by MacSween in 1978. We present a nine
years old boy who presented this rare lesion secondary to
casual fall. Typical mechanism of injury consists of falling
over the forearm in forced pronation, as it occurred in our
case here presented. Another mechanism described though
very uncommon is the iatrogenic presentation, when trying
reduction manoeuvres with the forearm in pronated position.
Initial diagnosis may be difficult due to the apparent good
reduction of the posterior dislocation, but radioulnar translocation
persists and can be neglected as in our case. Here
appropriate examination tests are described to avoid this
condition. Treatment by close manipulation usually leads to
poor results, and that is why open reduction is often advisable.
We recommend the lateral approach, with radial release
and annular ligament reconstruction. Associated fractures
and other complications are frequent. In this case we had
heterotopic ossifications that limited prono-supination range
of motion to 100º.
Palabras clave (ES):
Cúbito
Codo
Niño
Infancia
Infantil
Luxación
Traslocación
Radiocubital
Radio
Resumen (EN)
Isolated elbow dislocations are uncommon in children,
and usually they present associated to elbow fractures.
Elbow dislocation with proximal radioulnar translocation is
exceptional, and only nine cases had been reported. It was
first described by MacSween in 1978. We present a nine
years old boy who presented this rare lesion secondary to
casual fall. Typical mechanism of injury consists of falling
over the forearm in forced pronation, as it occurred in our
case here presented. Another mechanism described though
very uncommon is the iatrogenic presentation, when trying
reduction manoeuvres with the forearm in pronated position.
Initial diagnosis may be difficult due to the apparent good
reduction of the posterior dislocation, but radioulnar translocation
persists and can be neglected as in our case. Here
appropriate examination tests are described to avoid this
condition. Treatment by close manipulation usually leads to
poor results, and that is why open reduction is often advisable.
We recommend the lateral approach, with radial release
and annular ligament reconstruction. Associated fractures
and other complications are frequent. In this case we had
heterotopic ossifications that limited prono-supination range
of motion to 100º.
and usually they present associated to elbow fractures.
Elbow dislocation with proximal radioulnar translocation is
exceptional, and only nine cases had been reported. It was
first described by MacSween in 1978. We present a nine
years old boy who presented this rare lesion secondary to
casual fall. Typical mechanism of injury consists of falling
over the forearm in forced pronation, as it occurred in our
case here presented. Another mechanism described though
very uncommon is the iatrogenic presentation, when trying
reduction manoeuvres with the forearm in pronated position.
Initial diagnosis may be difficult due to the apparent good
reduction of the posterior dislocation, but radioulnar translocation
persists and can be neglected as in our case. Here
appropriate examination tests are described to avoid this
condition. Treatment by close manipulation usually leads to
poor results, and that is why open reduction is often advisable.
We recommend the lateral approach, with radial release
and annular ligament reconstruction. Associated fractures
and other complications are frequent. In this case we had
heterotopic ossifications that limited prono-supination range
of motion to 100º.
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