Surgical management of acute combined injuries of the ipsilateral wrist and elbow joints.

Background: Combined injuries of ipsilateral wrist and elbow joints are rare in clinical practice, characterized by multiple joint dislocations or/and fractures and varying manifestations. As there are still no clinical guidelines and no consensus on the standard treatment, this study aimed to explore the surgical intervention and complications of this kind of combined injuries. Methods: This retrospective study was conducted in a single center. A total of 13 patients with acute combined injuries of the ipsilateral wrist and elbow joints receiving surgical treatment from August 2013 to May 2016 were retrospectively analyzed. The fracture and joint instability and structural damages were repaired and reconstructed. Results: All 13 patients were followed up for a mean duration of 17 months (range: 14 to 22 months). The X-ray films showed good fracture reduction and joint alignment, no fixation failure, re-displacement, bone nonunion, or ischemic necrosis in all cases. According to the Mayo Elbow Performance Score (MEPS), the excellent and good rate of joint function was 84.6%. According to the Mayo Modified Wrist Score (MMWS), the excellent and good rate of joint function was 76.9%. There were no significant restrictions on elbow and wrist movements. The disabilities of the arm, shoulder, and hand (DASH) score was excellent, with an average of 18.5 points. Conclusions: The key to intervention of combined injuries of the wrist and elbow is to identify the types of injuries and conduct an overall assessment to determine the appropriate surgical methods. Early surgical intervention and rehabilitation exercise are the main principles for the treatment.

Severe injury of bilateral elbow joints with unilateral terrible triad of the elbow and unilateral suspected terrible triad of the elbow complicated with olecranon fracture: one case report.

Terrible triad of the elbow is characterized as posterior dislocation of the elbow joint accompanied by the fractures of the radial head and coronoid process of the ulna, which is rarely seen in clinical practice, especially because the mild fracture is barely detected by imaging method In this study, we reported one case of serious complex bilateral elbow injury, presenting with unilateral typical terrible triad of the elbow and suspected terrible triad of the elbow complicated with olecranon fracture on the other side. Clinical experience was obtained during the diagnosis and treatment procedures.

Chronic radial head dislocation caused by a rare solitary osteochondroma of the proximal radius in a child: a case report and review of the literature.

BACKGROUND: Osteochondroma is the most common benign bone tumor of the upper limbs that occurs during the developmental phase of children. Solitary epiphyseal enchondromas can be usually found in the humeral capitellum, and the proximal ulna of the elbow. CASE PRESENTATION: Herein, we report the case of a 12-year-old boy of Han ethnicity with a developmental radial head dislocation with a progressive radius deformities, caused by a solitary osteochondroma which originated from the proximal metaphysis of the radius. Obvious complaints and limitations were present. After tumor excision was performed, radial head reduction and deformity correction were achieved through a biplanar shortening osteotomy of the radius. CONCLUSIONS: After a follow-up of 18 months, the child remained asymptomatic and regained a full range of motion. Radiographic study revealed satisfactory reduction of the radial head with no recurrence of the osteochondroma.