A Peculiar Case of Open Complex Elbow Injury with Critical Bone Loss, Triceps Reinsertion, and Scar Tissue might Provide for Elbow Stability?

IF 1 Q3 ORTHOPEDICS
Giulia Facco, Rocco Politano, Andrea Marchesini, Letizia Senesi, Pasquale Gravina, Pier Paolo Pangrazi, Antonio P Gigante, Michele Riccio
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引用次数: 4

Abstract

Background: Complex elbow injuries (CEIs) are severe and rare lesions, difficult to treat correctly due to the different patterns of clinical presentations. Standard methods cannot often be applied. The main goals of the treatment are performing a stable osteosynthesis of all fractures, obtaining a concentric and stable reduction of the elbow by repairing the soft tissue constraint lesions, and allowing early motion. Since the introduction of virtual reality (VR) approaches in clinical practice, three-dimensional (3D) computed tomography (CT) and 3D printing have revolutionised orthopaedic surgeries, thus helping to understand the anatomy and the pathology of complex cases.

Case description: We discussed a case of CEI, characterised by an extended soft tissue (IIIB Gustilo classification) and neurovascular lesions associated with bone loss in a young female patient. Olecranon fracture was type IIIB according to Mayo classification. We outlined the steps of a pluri-tissue reconstructive approach and stressed the importance of 3D printing in the preoperative planning for such cases. Finally, peculiar final functional patient outcomes were reported.

Conclusion: In this case, we found out that triceps reinsertion and scar process may provide for the joint stability in a low-demanding patient. 3D printing and VR approaches in clinical practice can be useful in the management of CEIs associated with an important bone and soft tissue loss.

How to cite this article: Facco G, Politano R, Marchesini A, et al. A Peculiar Case of Open Complex Elbow Injury with Critical Bone Loss, Triceps Reinsertion, and Scar Tissue might Provide for Elbow Stability? Strategies Trauma Limb Reconstr 2021;16(1):53-59.

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开放性复杂肘关节损伤伴严重骨丢失的特殊病例,三头肌复位和瘢痕组织可能提供肘关节稳定性?
背景:复杂肘部损伤是一种严重而罕见的病变,由于其临床表现不同而难以正确治疗。标准方法往往不能适用。治疗的主要目标是对所有骨折进行稳定的骨整合,通过修复软组织约束病变获得肘关节同心稳定复位,并允许早期活动。自从在临床实践中引入虚拟现实(VR)方法以来,三维(3D)计算机断层扫描(CT)和3D打印已经彻底改变了骨科手术,从而有助于了解复杂病例的解剖和病理。病例描述:我们讨论了一个年轻女性CEI病例,其特征是软组织扩展(IIIB Gustilo分类)和神经血管病变与骨质流失相关。鹰嘴骨折按Mayo分型为IIIB型。我们概述了多组织重建方法的步骤,并强调了3D打印在此类病例术前规划中的重要性。最后,报告了特殊的最终功能患者结果。结论:在本例中,我们发现肱三头肌复位和瘢痕处理可以为低要求患者提供关节稳定性。3D打印和VR方法在临床实践中可以用于管理与重要骨和软组织丢失相关的CEIs。本文引用方式:Facco G, Politano R, Marchesini A,等。开放性复杂肘关节损伤伴严重骨丢失的特殊病例,三头肌复位和瘢痕组织可能提供肘关节稳定性?创伤肢体重建,2021;16(1):53-59。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Strategies in Trauma and Limb Reconstruction
Strategies in Trauma and Limb Reconstruction Medicine-Orthopedics and Sports Medicine
CiteScore
1.50
自引率
0.00%
发文量
31
期刊介绍: Strategies in Trauma and Limb Reconstruction is dedicated to surgeons, allied medical professionals and researchers in the field of orthopaedics and trauma. The scope of the journal is to discuss the fields of skeletal injury, and the complications thereof, congenital and acquired limb deformities and deficiencies, and orthopaedic-related infection, together with their surgical and non-surgical treatments. The journal publishes original articles, reviews, case reports, descriptions of new or recognised treatment techniques, forum discussions of clinical scenarios and relevant correspondence. It aims to provide a widely accessible source of useful information to practitioners in the field through the problem- or technique-based approach of published articles.
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