Surgical Treatment of an Open Elbow Dislocation with Vascular Injury: A Case Report - - - Hirurško lečenje otvorene luksacije lakta sa povredom magistralnih krvnih sudova: prikaz slučaja
Journal Title: Acta Facultatis Medicae Naissensis - Year 2017, Vol 34, Issue 1
Abstract
Open elbow dislocations with vascular injury are rare injuries and they most commonly occur after a fall from a high or in sports accidents. Close anatomic proximity of the joint to the neurovascular structures put them at risk of concomitant injury. The aim of this paper is to present the method of treatment of this severe injury. Herein we present a case of a female patient, 43 years old. She had suffered an open elbow dislocation with vascular injury as a result of a fall from the height of 1.5 meters. Seven hours after sustaining the injury and short preoperative preparation, reposition of the elbow, reconstruction of the vascular injury, adequate surgical treatment of the wound and external fixation of the elbow with the Mitković type external fixator were performed under general anesthesia. Four weeks after elbow stabilization with the external fixation, the external fixator was removed. The neurovascular status and final functional result of the treatment after six mounts were good. Urgent reposition, artery and vein reconstruction, and external fixation are essential in achieving good results in patients with open cubital dislocation accompanied with vascular injury. The Mitković type external fixator provides fast and stable fixation of the elbow after reposition and good conditions for wound care. - - - Otvorene luksacije lakta su retke povrede i najčešće nastaju pri padu sa visine i sportskom trauma-tizmu. Zbog anatomske blizine neurovaskularnih struktura praćene su rizikom oštećenja nerava i ma-gistralnih krvnih sudova ruke. Cilj rada bio je da se prikaže način lečenja ove teške povrede. U radu se prikazuje žena stara 43 godine, koja je zadobila otvorenu luksaciju levog lakta nakon pada sa traktorske prikolice (visina oko 1,5 m) na opruženu ruku. Nakon sedam sati od povrede, urađena je repozicija lakta nakon obilnog ispiranja rane, sutura kapsule zgloba i rekonstrukcija pokidanih magistralnih krvnih sudova autovenoznim graftovima uz fasciotomiju od strane vaskularnog tima. Nakon toga, urađena je stabilizacija zgloba lakta spoljnim skeletnim fiksatorom Mitković. Spoljni fiksator je skinut nakon četiri nedelje. Neurovaskularni status leve ruke i funkcionalni rezultat nakon 6 meseci od povre-đivanja i sprovedene fizikalne terapije bio je dobar. Blagovremena repozicija, rekonstrukcija oštećenih magistralnih krvnih sudova i spoljna skeletna fiksacija lakta predstavljaju bazične elemente u spašavanju i funkcionalnom oporavku ruke nakon otvorene luksacije lakta sa pratećem vaskularnom povredom. Spoljni skeletni fiksator Mitković omogućava brzu i stabilnu fiksaciju lakta nakon repozicije i zbog unilateralne montaže sa lateralne strane, obezbeđuje odlične uslove za negu rane.
Authors and Affiliations
Predrag Stojiljković, Milan Jovanović, Ivan Golubović, Marko Mladenović, Aleksandar Tošić
Keywords
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- EP ID EP347612
- DOI 10.1515/afmnai-2017-0009
- Views 67
- Downloads 0
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