Complex open elbow fracture Gustilo-Anderson type IIIB treated with the primary elbow arthroplasty: A case report

Total elbow arthroplasty as a treatment option for open elbow fracture is relatively rare described.We reported a 39 years old polytrauma patient with complex open elbow fracture(Gustilo-Anderson type IIIB).The patient presented with large soft tissues defect on dorsal part of the left elbow,ulnar palsy due to the irreparable loss of the ulnar nerve,distal triceps loss due to the complete loss of the olecranon,loss of both humeral condyles with collateral ligaments and complex elbow instability.Only few similar cases have been published.Reconstructive surgery included repetitive radical debridement,irrigation,vacuum assisted closure system therapy,external fixation,coverage of the soft tissue defect with fascia ecutaneous flap from the forearm.Four months after the injury,total elbow arthroplasty with autologous bone graft(from the proximal radius)inserted in the ulnar component,was performed.At 3 years postoperatively,the patient is able to perform an active flexion from 0to 110with full pronosupination.Only passive extension is allowed.The ulnar neuropathy is persistent.Patient has no signs of infection or loosening of the prosthesis.

The Effect of Weather Conditions on Pediatric Supracondylar Humerus Fractures

Background: Environmental conditions are effective on childhood supracondylar humerus fractures. In this study, we evaluated the relationship between weather conditions and these fractures. Materials and Methods: We started this study following the approval of a non-interventional research ethics committee. Patients (<16 years) who applied to the hospital between January 2013 and July 2018 with supracondylar humerus fractures were included in the study. The hospital’s PROBEL system was used to diagnose (International Classification of the Diseases, ICD, S42.4) radiological images and patient information. Information on the weather conditions in the day and time period, in which supracondylar humerus fracture occurred, was obtained from TR (Turkey) Ministry of Agriculture and Forestry General Directorate of Meteorology. The relationship between supracondylar fracture and daily weather conditions (wind, air temperature, cloudiness, and season) was analyzed. Results: Most of the patients (n = 76, 40.6%, p < 0.05) were fractures occurring under cloudless weather conditions. Fractures were concentrated with a second frequency in cloudy weather over 60%, except for cloudless weather conditions (n = 51, 27.3%, p < 0.05). In the summer months when the air temperature was high, the number of fractures was higher (n = 62, 33.2%, p < 0.05) and less in the winter months (n = 24, 12.8%, p < 0.05). In hot weather conditions where the daily average temperature was above 20°C, supracondylar humerus fractures were observed more (n = 101, 54%) and less than 10°C (n = 43, 23%, p < 0.05). Increased incidence of fractures was observed in the presence of wind (n = 4, 2.1%, p < 0.05). Conclusion: Supracondylar humerus fractures are common in children. Environmental conditions (temperature, wind, and season) can be effective in the occurrence of these fractures.

Elbow dislocation with ipsilateral diaphyseal forearm bone fracture： A rare injury report with literature review

Dislocation of the elbow along with shaft fractures of both bones of the ipsilateral forearm is a rare injury though elbow dislocation or fracture of the forearm bones may occur separately. Such injuries need a concentric reduction of the dislocation and an anatomical fixation of forearm bones for optimal functional outcomes. We report a case of elbow dislocation with fracture of the lateral condyle of the hu- merus along with fractures of shafts of the radius and ulna in a 44-year-old female. Closed reduction of the elbow and operative stabilization of all fractures were done with good clinical, radiological and functional outcomes in 2 years follow-up period. A significant degree of force is needed to produce a combined dislocation of a joint and fracture of bones around that joint and these complex injuries may be missed if the clinician is not aware of the possibility of such injuries. The fact that the previously reported cases had a posterolateral dislocation while our case had a posteromedial dislocation and a fracture of the lateral humeral condyle as well makes it unique in its presentation and worth reporting. We have also included an up to date literature review on this topic.

An unusual Monteggia equivalent type 1 lesion： Diaphyseal ulna and radius fractures with a posterior elbow dislocation in a child

In this report, we describe an extremely unusual Monteggia equivalent type 1 lesion in a 10-year-old boy following a fall from a height of I m. On the plain radiographs, our patient had a particular Monteggia equivalent type 1 injury associating a posterior elbow dislocation with diaphyseal radius and ulna fractures. The patient was treated by closed reduction technique. At six months of follow-up, the frac- tures were consolidated and the elbow was stable. To our knowledge, only 8 adult cases and one pae- diatric observation with similar lesions had been reported through medical literature. Therefore, the aim of our case report is to remind this rare entity and also to provide a comprehensive review of the literature related to this uncommon lesion.