(Disclaimer: This article is for general science purposes only, and relevant information in the following content has been processed to protect patient privacy)
Abstract: This 18-year-old patient fell with his palm on the ground, his forearm in a rotated forward position, and his elbow in a slightly flexed position, and the violence was transmitted from the radius to the radial head and then impacted on the humeral epicondyle, resulting in a fracture of the lower humerus. After the fracture, localized swelling in the elbow joint gradually spread and limited the joint movement, and 3D CT was taken to confirm the fracture and displacement of the lower humerus. After surgical treatment, the stability of the fracture end was restored and the fracture was initially healed due to the impact on the joint surface.
Basic information】Male, 18 years old
Disease Type】Inferior humeral fracture
Hospital】Harbin First Hospital
Date of consultation】December 2021
Treatment plan】Internal fixation with incisional repositioning screws
Treatment Period】7 days of inpatient treatment and outpatient follow up
Results】The fracture was fixed, the pain was relieved, and the range of motion of the elbow joint was restored.
I. Initial consultation
The patient was an 18-year-old boy. When he came to the hospital, I observed that his elbow joint was swollen, and he complained of pain and limitation of movement, and was found to have a local fracture deformity. After the fracture of the elbow joint, although the fracture heals relatively quickly, the recovery of joint function is relatively slow, and the patient was fully aware of this before admission.
II. Treatment history
Since conservative treatment could not completely anatomically reset the fracture of the lower humerus and, therefore, would affect the function of the elbow joint, the patient opted for surgical treatment. Through surgical treatment, it was confirmed that the patient had a fracture of the lower humerus with significant displacement of the fracture end, and was able to restore the flexion and extension of the elbow joint after fixation with a fracture reduction clamp. The anatomical repositioning of the fracture end was confirmed under fluoroscopy, and final fixation was performed with screws. After fixation, the patient’s elbow was moved passively without restriction of motion, the surgical incision was irrigated and sutured, and the elbow was fixed in a neutral position after surgery. Once the swelling and pain were reduced, the patient was instructed by the rehabilitation physician to complete the flexion and extension activities of the elbow joint, and to gradually restore the function of the elbow joint with local cold compresses.
III. Treatment effect
After 7 days of hospitalization, the swelling and pain of the joint and the limitation of movement were gradually improved, and the patient was able to complete the flexion and extension activities of the elbow joint on his own initiative. After 3 months, the patient was followed up in the outpatient clinic, and the positive and lateral radiographs of the elbow joint were reviewed, confirming that the internal fixation screws were stable and the fracture ends were gradually forming bone scabs, which eventually led to complete healing and restoration of elbow joint function. Finally, the fracture was completely healed and the function of the elbow joint was restored.
Precautions
After the surgery, the patient’s clinical symptoms such as elbow pain were significantly reduced and the function of the elbow joint was gradually restored to the pre-injury level, although I was very happy for the patient.
However, due to the presence of screws inside the fracture, he was advised to avoid strenuous sports, such as basketball and rugby, for one year to prevent the internal fixation from breaking, and to gradually resume strenuous sports after removing the internal fixation after one year. Patients are also reminded to relax and actively cooperate with the treatment and recovery, active rehabilitation, in general, rarely produce traumatic arthritis, the function of the elbow joint can be guaranteed, normal life, work and sports will not be significantly affected.
V. Personal insight
This patient had a fracture of the lower end of the humerus, and after early diagnosis and early treatment, the fracture end was anatomically repositioned, and the flatness of the joint surface was restored as much as possible to protect the function of the elbow joint. At the same time, due to the appropriate rehabilitation training, the prevention of deformity healing of the elbow joint is of great importance for the patient’s future life, work and sports. Patients should actively engage in rehabilitation training after surgical treatment, while avoiding trauma to the elbow joint and preventing the use of the palm of the hand when falling to prevent the reoccurrence of the lower humeral fracture.