Unusual combination of elbow dislocation with a retained intraarticular fragment and trochlear fracture and ipsilateral distal radius fracture in an amateur snowboarder: A case report and review of literatures

Abstract

Introduction: The most common damage caused by snowboarding is wrist injury. However, Elbow injuries are relatively rare. In general, elbow dislocation with ipsilateral distal radius fracture is also very rare. Presentation of case: We present an 18-year-old right hand dominant male with distal radius extra articular fracture and elbow fracture dislocation. Computed tomographic scan and Magnetic resonance image of elbow joint showed retained intra-articular fragment, trochlear fracture, and the humeral attachment site of lateral collateral ligament (LCL) with rupture. The ruptured LCL was repaired, and then, the distal radius fracture was fixed with a volar distal radius locking plate. At one year after surgery, the patient did not complain of any subjective symptoms or functional deficit. Discussion: The injury mechanism would fall into the outstretched arm state, leading first to hyperextension of the wrist, resulting in fracture of the distal radius. The remaining force is then applied to the elbow joint by an external rotation and valgus moment arm, resulting in the rupture of the LCL of the elbow joint. In this state, the remaining force is transmitted through the olecranon to the trochlea as a shear force, resulting in osteochondral fracture and subsequent dislocation of the elbow joint. Conclusion: Combined injury of extremity from snowboarding is relatively rare, but we experienced a case of elbow dislocation combined with distal radius fracture caused by fall on outstretched hand on the snow surface during snowboarding in a young adult. (C) 2019 The Authors. Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd.