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Age: 33

Sex: Male

Indication: Gunshot wound

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Case #27


Findings

  • Acute open, comminuted fracture of the proximal ulna with a transverse component just distal to the coronoid process and a longitudinal component with proximal intraarticular extension via the lateral aspect of the coronoid process
  • Anterior dislocation of the radial head with slight proximal migration
  • Soft tissue swelling and subcutaneous emphysema about the elbow


Diagnosis

  • Open elbow fracture/dislocation

Sample Report

Acute open elbow fracture/dislocation with anterior dislocation and proximal migration of the radial head and a comminuted fracture of the proximal ulna with a transverse component just distal to the coronoid process and a longitudinal component with proximal intraarticular extension via the lateral aspect of the coronoid process.

Ulnotrochlear alignment is maintained.

Soft tissue swelling and subcutaneous emphysema about the elbow. No retained radiopaque foreign body.


Discussion

  • Remember to talk about displacement, comminution, and joint subluxation/dislocation when describing complex fracture cases
  • Also make sure to look for soft tissue gas, which raises concern for open fracture



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