The false equivalent of terrible triad of elbow combined with neurovascular damage in a rugby player - A new case report.

Hassan BOUSSAKRI, Abdelhalim Elibrahimi, Ihab Alassaf, Mohammed Bachiri, Abdelghani ELayoubi, Abdelmajid Elmrini

Abstract


 

Terrible triad is a severe traumatic injury of the elbow. We report a new variety of this clinical entity originating from a rare combination of injuries, namely the fracture-dislocation of the right elbow. The symptoms are acute ischemia of the hand with neurological damage following a sport accident suffered by a professional rugby player. We treated him surgically after immediate reduction of the dislocation. The short-term monitoring was clinical, while in the medium-term it was radiological and electrophysiological. On the whole, our (clinical, electrophysiological and radiological) results obtained initially, and medium-term during the last consultation, were satisfactory. The objective of this study is to draw attention to this clinical and radiological variety, as well as to its neurovascular complications and to discuss its therapeutic treatment. During the vascular and neurologic exam we should pay attention to and systematically look for neurovascular complications when treating a similar clinical case.


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References


REFERENCES

Hotchkiss RN. Fractures and dislocations of the elbow .In: Rockwood CA, Green DP, Bucholz RW, Heckman JD, editors. Rockwood and Green’s fractures in adults, 1, 4th ed. Philadelphia: Lippincott-Raven; 1996: 929—1024

Yin Y, Zhao Y. Case-control study on the operative treatment for terrible triad of the elbow. Zhongguo Gu Shang. 2014 Jan;27(1):41-5.

Ring D, Jupiter JB, Zilberfarb J. Posterior dislocation of the elbow with fractures of the radial head and coronoid. J Bone Joint Surg Am 2002,84-A:547–5511-5.

Sharma H, Sibinski M, Sherlock DA. Outcome of lateral humeral condylar mass fractures in children associated with elbow dislocation or olecranon fracture. Int Orthop 2009,33:509–514.

Exarchou EJ. Lateral dislocation of the elbow. Acta Orthop Scand 1977;48(2):161–3

Hidalgo Ovejero AM, Garcia Mata S, Ibarra Zulategui P, Heras Izaguirre J, Martinez Grande M. Luxation antérieure du coude sans fracture d’olécrâne associée. Rev Chir Orthop 1988 ; 74 : 257-258.

Linscheid RL, O’Driscoll SW. Elbow dislocations. In : Morrey BF ed. The elbow and its disorders. Philadelphia :WB Saunders, 1993 : 441-452.

Grimer RJ, Brooks S. Brachial artery damage accompanying closed posterior dislocation of the elbow. J Bone Joint Surg 1985 ; 67B : 378-381

Pearce MS. Radial artery entrapment. A rare complication of posterior dislocation of the elbow. Int Orthop 1993 ;17: 127-128.

Sparks SR, DeLaRosa J, Bergan JJ et al. Arterial injury in uncomplicated upper extremity dislocations. Ann Vasc Surg 2000,14(2):110–113.

Slowik GM, Fitzimmons M, Rayhack JM. Closed elbows dislocation and brachial artery damage. J Orthop Trauma 1993,7(6):558–561.

Louis DS, Ricciardi JE, Spengler DM. Arterial injury: a complication of posterior elbow dislocation. J Bone Joint Surg 1974; 56A: 1631-1636.

Cormier JM, Firouzabadie H, Delouvrier J. Lésions vasculaires au cours des luxations du coude. Chirurgie 1975 ; 101 : 349-354.

Hotchkiss RN, Green DP. Fractures and dislocations of the elbow. In : Rockwood CA, Green DP, Bucholz RWeds. Fractures in adults. Philadelphia : JB Lippincott 1991 : 739-795.

Brahmamdam P, Plummer M, Modrall JG, Megison SM, Clagett GP, Valentine RJ. Hand ischemia associated with elbow trauma in children. J Vasc Surg. 2011 Sep;54(3):773-8.

Hofmann D, Schüz W, Horas U.Traumatic rupture of the brachial artery due to a closed elbow joint dislocation Unfallchirurg. 2011 Sep;114(9):816-21.

Rana NA, Kenwright J, Taylor RG. Complete lesion of the median nerve associated with dislocation of the elbow joint. Acta Orthop Scand 1974;45(3):365–9

Fourrier P, Levai JP, Collin JP. Incarcération du nerf médian au cours d’une luxation du coude. Rev Chir Orthop 1977;63(1):13–6.

Bonvallet JM. Paralysie du nerf médian après incarcération dans une luxation du coude. Ann Chir 1977;31(4):345–9.




DOI: http://dx.doi.org/10.15342%2Fijms.v1i2.47

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Université Mohammed VI des Sciences de la Santé