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Age: 30

Sex: Male

Indication: Gunshot wound

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Case #17


Findings

  • Acute comminuted fractures involving the sublime tubercle of the ulna and medial aspect of the trochlea with multiple tiny ossific fragments projecting along the medial aspect of the elbow joint
  • Subcutaneous emphysema about the elbow


Diagnosis

  • Sublime tubercle fracture

Sample Report

Acute comminuted fractures involving the sublime tubercle of the ulna and medial aspect of the trochlea with multiple tiny ossific fragments projecting along the medial aspect of the elbow joint.

No joint malalignment.

No joint effusion.

Joint spaces are maintained.

Subcutaneous emphysema about the elbow consistent with penetrating injury. No retained radiopaque foreign body.


Discussion

  • Always look closely for subcutaneous or intraarticular gas to raise concern for open fracture
  • Just like Segond fractures in the knee, the sublime tubercle should be a specific part of your search pattern to avoid missing these fractures


Images

Red arrow: multiple tiny fracture fragments originating from the sublime tubercle and likely also from the medial aspect of the trochlea.

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