PMC6374697_01
Simple radiopraphs of the left wrist and elbow at the time of injury demonstrate a distal radius fracture and posterior dislocation of the elbow joint.
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There was posterior dislocation of left elbow joint without definite fracture and extraarticular fracture of distal radius with volar angulation on simple radiographs (Fig. 1).
A and A' CT scan of the left wrist demonstrate AO/OTA classification type A3 distal radius fracture. B and B' Sagittal CT scan of the left elbow joint demonstrate coronoid tip fracture, trochlea osteochondral fracture, and intraarticular osseous body in elbow joint. C and C' Axial CT scan of the left elbow joint demonstrate trochlea osteochondral fracture, and intraarticular osseous body in elbow joint.
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However, retention of an intraarticular osseous body from cortex of just beneath radial facet of proximal ulna was found in the ulnohumeral joint (Fig. 2).
A and B, T2 coronal view of the left elbow demonstrate lateral collateral ligament rupture. C, T2 sagittal view of the left elbow demonstrate posterior subluxation of radial head. D, T2 sagittal view of the left elbow demonstrate trochlear osteochondral fracture and coronoid process tip fracture.
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The posterior subluxation of radial head was observed (Fig. 3).
A, Intraoperative gross picture demonstrate intraarticular osseous body. B, Intraoperative gross picture demonstrate complete avulsion of the lateral collateral ligament (LCL) from the humeral attachment site was noticed along with partial avulsion of the common extensor origin and the annular ligament(Arrow head: lateral collateral ligament and common extensor origin, *: Radial head) C and C', Immediate postoperative simple radiographs of the left wrist. D and D', Immediate postoperative simple radiographs of the left elbow.
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We found completely avulsed LCL from its humeral attachment site and partial rupture of common extensor origin and the annular ligament during dissection (Fig. 4B). After exposing radiocapitellar joints, we applied valgus stress and widened the joint space to find the intraarticular osseous body, which was removed using a suction device (Fig. 4A).