Presentation
Slipped and fall while walking today morning, the patient hit his left forearm/ left elbow forcefully against the ground. (+) tenderness upper half of left forearm, anterior aspect; (+) tenderness, posterior aspect of the left elbow.
Patient Data
A displaced fracture in the middle third of the left radius with inferior dislocation in the radial head is seen.
Control XR after surgical Rx
The X-ray showed excellent alignment.
Internal fixation by plate and screws.
Skin staplers
External volar slab
Case Discussion
Humeroradial distance between the capitellum and radial head is 10 mm in keeping with a dislocation.
Ipsilateral radial head dislocation with radial shaft fracture without any other associated injury is quite rare.
In this type of radial fracture associated with dislocation of the radial head, early surgical intervention is performed.
On follow-up the patient was re-evaluated in the hospital where it was found by clinical examination:
- patient skin on the left arm was intact.
- mild swelling and tenderness was found
- no neurovascular deficit (motor function and sensation are intact)
- the radial pulse was palpable
A decision was made that the case needs surgical intervention.
- preoperative diagnosis
- displaced left radial shaft fracture with radial head dislocation
- intraoperative notes:
- modified Henry approach
- open reduction and internal fixation using 7-holes 3.5DCP plate
- skin staplers
- volar slab applied
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