Fracture Trochlea In Coronal Plane Associated With Floating Elbow: Rare Combinations Of Injuries

摘要

We present a case of uncommon entity of fracture of trochlea in the coronal plane associated with a floating elbow of the ipsilateral extremity in a twenty years old male which is not reported in literature. Presence of bone fragment in front of the distal humerus but medial to medial epicondyle is suggestive of fracture of the trochlea in the coronal plane. Introduction Isolated fractures of trochlea in the coronal plane are a rare clinical entity because they are situated deep within the olecranon and forces transmitted through the coronoid process of the ulna are compressive rather than shearing.1, 2 Fracture of the trochlea is accomplished by the other elbow injuries like elbow dislocation, fracture of capitellum, fracture of ulna and extra articular condylar fracture with or without ulnar nerve injury. 2 We present a case of combination of shear fracture of trochlea (AO/ASIF classification: 13 B 3.2) associated with floating elbow (12 A 2.2 and 22 A 3.2). 3 Literature search reveled no previous reports of such combination of injuries. Material and method Twenty years old right handed sugar mill factory worker presented after two days of motor vehicle accident with pain and swelling of right upper extremity. Clinical examination revealed blisters over arm, swollen elbow and forearm with tenderness over medial aspect elbow, arm and forearm. Neuro-vascular functions were intact. Radiographs revealed bone fragment in front of distal humerus on lateral view and medial to midline but distal to medial epicondyle on anterio-posterior view; suggestive of fracture trochlea in coronal plane and diaphyseal fracture of humerus and ipsilateral fracture of both bones forearm. (Fig.1)