@article{HabartaJordanMeffertetal., author = {Habarta, Johanna and Jordan, Martin and Meffert, Rainer and Huflage, Henner and Schmalzl, Jonas}, title = {Surgical management of a traumatic elbow dislocation with disruption of the brachial artery. Case report}, series = {Obere Extremit{\"a}t}, volume = {17}, journal = {Obere Extremit{\"a}t}, number = {4}, issn = {1862-6599}, doi = {10.1007/s11678-022-00686-9}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-323972}, pages = {267-271}, abstract = {Background Dislocations of the elbow are the second most common dislocations of humeral joints following the shoulder. Besides numerous possible concomitant injuries of the collateral ligaments or the extensor or flexor apparatus, an accompanying disruption of the brachial artery is a rare occurrence. In the following, such a case is presented and discussed. Method A 70-year-old woman sustained a closed posterior elbow dislocation with accompanying disruption of the brachial artery due to a fall in a domestic environment. Pulselessness of the radial artery led to a computed tomography angiography being performed, which confirmed the diagnosis. Direct operative vascular reconstruction with a vein insert was carried out. Due to strong swelling of the soft tissue, other examinations of the elbow could not be performed initially. A redislocation a few days later led to an operative stabilization of the elbow joint. Results The final consultation 4 months postoperatively showed a stable, centered elbow joint and a normal perfusion of the affected arm. The elbow function was good with a range of motion of 0/0/110° of extension/flexion. Conclusion An elbow dislocation is a complex injury. An accurate clinical examination of possible concomitant injuries is important and should be repeated in the first few days after the occurrence. Vascular reconstruction should be performed immediately. In the case of persistent joint instability, an operative stabilization is indicated and may be supported by a hinged external fixator.}, language = {en} } @article{SchmidLoisMetzetal.2022, author = {Schmid, Andrea and Lois, Anna-Maria and Metz, Corona and Grunz, Jan-Peter and Veldhoen, Simon}, title = {Not all that looks fractured is broken - multipartite humeral epicondyles in children}, series = {European Radiology}, volume = {32}, journal = {European Radiology}, number = {8}, doi = {10.1007/s00330-022-08670-1}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-324987}, pages = {5045-5052}, year = {2022}, abstract = {Objective Multipartite epicondyles may mimic fractures in the setting of pediatric elbow trauma. This study examines the prevalence of multipartite epicondyles during skeletal development and their association with pediatric elbow fractures. Materials and methods In this retrospective analysis, 4282 elbow radiographs of 1265 elbows of 1210 patients aged 0-17 years were reviewed. The radiographs were analyzed by two radiologists in consensus reading, and the number of visible portions of the medial and lateral epicondyles was noted. For elbows in which epicondylar ossification was not yet visible, the epicondyles were already fused with the humerus or could not be sufficiently evaluated due to projection issues or because osteosynthesis material was excluded. In total, 187 elbows were included for the lateral and 715 for the medial epicondyle analyses. Results No multipartite medial epicondyles were found in patients without history of elbow fracture, whereas 9\% of these patients had multipartite lateral epicondyles (p < 0.01). Current or previous elbow fractures increased the prevalence of multipartite epicondyles, with significant lateral predominance (medial epicondyle + 9\% vs. lateral + 24\%, p < 0.0001). Including all patients regardless of a history of elbow fracture, multipartite medial epicondyles were observed in 3\% and multipartite lateral epicondyles in 18\% (p < 0.0001). There was no gender difference in the prevalence of multipartition of either epicondyle, regardless of a trauma history. Conclusion Multipartite medial epicondyles occur in patients with current or previous elbow fractures only, whereas multipartite lateral epicondyles may be constitutional. Elbow fractures increase the prevalence of multipartite epicondyles on both sides, with significant lateral predominance. Key Points • Multipartite medial epicondyles should be considered of traumatic origin. • Multipartite lateral epicondyles may be constitutional. • Elbow fractures increase the prevalence of multipartite epicondyles on both sides with lateral predominance.}, language = {en} }