Unorthodox Treatment of a Very Rare Forearm Injury

Abstract

Injury patterns are becoming more extensive due to an increasing number of high-energy injuries. This case report describes a very extensive forearm injury pattern. An unstable elbow fracture with concomitant fractures, a displaced intra-articular distal radius fracture and a scapholunate dissociation were treated with two connected external fixators and Kirschner wires. While remaining minimally invasive and tissue preserving, clinical outcome, radiographs and questionnaires did show a satisfactory result. Classical treatments are of great value for application in many injury patterns. However, with new and extensive injuries such as the one described in this case report, it is important to think out of the box and combine treatments that may ordinarily not have been placed together.

elbow dislocation - intra-articular distal radius fracture - scapholunate dissociation - extended injury pattern

References

• 1 Broos P L, Fourneau I A, Stoffelen D V. Fractures of the distal radius. Current concepts for treatment.  Acta Orthop Belg. 2001;  67 211-218
• 2 Flanigan D C, Kaplan L D. Elbow dislocations and instability.  Current Opinion in Orthopaedics. 2004;  15 280-285
• 3 Hildebrand K A, Patterson S D, King G JW. Acute elbow dislocations: simple and complex.  Orthopedic Clinics of North America. 1999;  30 63-79
• 4 Jupiter J B, Ring D. Treatment of unreduced elbow dislocations with hinged external fixation.  J Bone Joint Surg [Am]. 2002;  84 1630-1635
• 5 Kapandji A. Internal fixation by double intrafocal plate. Functional treatment of non articular fractures of the lower end of the radius.  Ann Chir. 1976;  30 903-908
• 6 O'Driscoll S W, Jupiter J B, King G JW, Hotchkiss R N, Morrey B F. The unstable elbow.  J Bone Joint Surg [Am]. 2000;  82 724-738