PMC8636899_01
(A,B) Anteroposterior and lateral view of the left elbow present a supracondylar fracture of the humerus (Gartland type III). (C) Anteroposterior radiograph after the first surgery shows the fracture reduced with cross pinning. (D) Radiograph of the left elbow show some calcificated tissue around the elbow 3 months after the first operation.
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F1
X-ray showed supracondylar fracture of the humerus classified as Gartland type III (Figures 1A,B). An open reduction was performed by the orthopedic surgeon for adult through the postcubital approach and the fracture was fixed with one lateral and one medial pin (Figure 1C). The elbow became swollen on the tenth day of rehabilitation, and the X-ray taken on the same day showed some tissue calcificated around the elbow joint (Figure 1D).
(A,B) Radiograph of the left elbow depicts the bridging myositis over the elbow 9 months after the primary injury. (C) MRI presents the bony myositis between distal humerus and proximal ulna with a smooth elbow joint. (D,E) CTA show brachial artery and the medial artery passing around the bony bridge. Line a and b represent longitudinal incisions along the lateral distal humerus and the medial proximal ulna respectively.
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F2
The practice went on and the limited range on elbow motion aggravated, and so was the calcificated tissue (Figures 2A,B). Laboratory tests, magnetic resonance imaging (MRI) (Figure 2C) and computed tomography angiography (CTA) (Figures 2D,E)were performed.
Bony myositic mass excised is about 9 x 2 cm.
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F3
By this way the bone bridge was completely dissected from the bases and extracted from the humeral incision after thorough blunt dissection of the middle part (Figure 3).
(A) Pre-operative photos shows a 40 degrees rigid flexion deformity of the left elbow. (B) Photograph of the left elbow after 2 year of the second operation shows a range of motion from 20 to 120 degrees. (C,D) Anteroposterior and maximum-flexion lateral radiograph of the elbow suggest no signs of recurrence.
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F4
Five months later the elbow was totally fixed at 40 degrees of flexion (Figure 4A). Two-year after operation, the range of motion was significantly improved to about 100 degrees (Figure 4B). Radiographs showed no recurrence of bone bridge (Figures 4C,D).