PMC6081541_01
Radiographs of the injury and first surgery at the previous hospital. (a) Anteroposterior (AP) view of the forearm and elbow. (b) AP view of the humerus and elbow. Diaphyseal fracture of humerus, olecranon fracture, and lateral epicondylar fracture are found. (c) AP view and (d) lateral view of the elbow after surgery. The olecranon is fixed by tension band wiring. The lateral epicondylar fracture is displaced with normal joint congruence.
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Radiological examinations revealed that he had suffered right traumatic pneumothorax, right humeral shaft fracture, right olecranon fracture, right scapular fracture, and right radial nerve palsy (Figures 1(a) and 1(b)). After respiratory system stabilization, the right olecranon and humeral shaft were operated on 11 days after the injury (Figures 1(c) and 1(d)).
Radiographs and computed tomography (CT) image 3 months after surgery. (a) AP view and (b) lateral view of the elbow. The avulsed fracture of the lateral epicondyle is displaced, the radiohumeral joint is widened in the AP view, and the posterior subluxation of the radial head is widened in the lateral view. The joint congruency of the ulnohumeral joint is maintained. (c) CT image in the coronal plane, (d) sagittal view, and (e) axial view. The displaced lateral epicondylar fracture is malunited.
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Plain radiography and computed tomography at three months after the injury showed that the avulsion fracture of the lateral epicondyle became displaced and malunited, the radiohumeral joint had widened on the anteroposterior view, and the posterior subluxation of the radial head had widened on the lateral view (Figures 2(a)-2(e)).
Intraoperative images. (a) After osteotomy of the displaced lateral epicondylar fracture, the fragment contains lateral collateral ligament and extensor muscles. (b) The resected fragment. The size of the fragment is 27 mm in length.
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The fragment contained the origin of the LCL complex and extensor muscles (Figure 3(a)). The fragment size was 27 mm in length (Figure 3(b)).
Radiographs 2 years after surgery. (a) AP view and (b) lateral view. Humeroradial joint congruency is good without osteoarthritic change.
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The radiographs showed normal congruence of the elbow joint without osteoarthritic change (Figures 4(a) and 4(b)).