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Chir Main ; 26(4-5): 221-6, 2007.
Artigo em Francês | MEDLINE | ID: mdl-17888711

RESUMO

"Traffic elbow" is a condition occurring when high energy trauma involves a patient's elbow resting on the window of the car or completely outside it. This is a prospective study over 30 months of 9 patients with "traffic elbow" and therefore sufferring complex open trauma to the elbow. There were 8 men and 1 woman with a median delay of 4 hours before arrival in hospital. The dominant member was affected in 3 cases. The severity of the lesions, using the Mangled Extremity Severity Score (MESS), was more than 7, comprising lesions corresponding to type 1 of the complex trauma of the superior member (TCMS) in 2 patients and a MESS score of between 3 and 6 corresponding to types 2 or 3 of the TCMS for the other 7 patients. The therapeutic possibilities are limited considering the frequent context of polytrauma. In 4 cases we performed a debridement and external humero-ulnar fixation, in 3 cases a debridement and stabilization with Kirschner's wires completed by a fenestrated cast, and in 2 cases a lifesaving amputation. All patients, except those that had had amputation, developed deep sepsis that resolved after adequate treatment. Assessment of the non-amputee patients according to the Mayo Performance Score, yielded more than 70% of bad results. The authors stress the gravity of these lesions whose prognosis is guarded both concerning mobility of the elbow and the frequent neurovascular complications.


Assuntos
Acidentes de Trânsito , Lesões no Cotovelo , Cotovelo/cirurgia , Adulto , Amputação Cirúrgica , Moldes Cirúrgicos , Desbridamento , Feminino , Fixação de Fratura , Humanos , Fraturas do Úmero/cirurgia , Escala de Gravidade do Ferimento , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fraturas da Ulna/cirurgia
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