FRACTURE OF THE "EMINENCE CAPITATA" ELBOW rights associated with radial nerve injury and fractures of the carpal navicular bone on the same side.

NAME: PATRICIA SALVO.

AGE: 39 YEARS AT TIME OF ACCIDENT.

ACCIDENT DATE: AUGUST 20, 2009.

CAUSE OF INJURY: While driving a motorcycle fender in the same locked the rear wheel and the patient was dismissed from his vehicle.

At the time of admission the patient had a fractured right elbow, was looking after the little minutes of the crash and went unnoticed, just a touch of the radial nerve that was demonstrated after surgery and was resolved spontaneously. This led my doubts at first whether the touch of the radial nerve was produced by the surgery and the accident itself. The development and consultation with other specialists determined that the injury occurred in the accident.

But do not forget the distal neurological examination even if the case involves a recent neurapraxia could have been negative because it raises doubts later. The omission of this review was given by the emergency, however is a simple test that should not be ignored.

Typical attitude I've seen in several patients when presenting input radial injury.

RX. Front. Initial radiograph.

RX. Profile. Initial. Same as above.

External approach was performed elbow. It was very difficult to reduce because the fragment was embedded between the radius and ulna, whichever section the annular ligament of radius for the purpose of achieving greater mobility and remove the fragment.

Once located he was raised a major dilemma: KEEP OR REMOVE TOTALLY FREE EXTRACT muscle attachments and the risk of necrosis.

He acted with a conservative approach and dropped the fragment positioned and stabilized with Kirschner wires.

RX. Front. Two and half months of evolution. The Kirschner was extracted at two months after the operation the patient.

RX. Front. Five months. The fragment is more established and there was necrosis of the same.

RX. Profile fist right where there is no fracture of the carpal scaphoid.

RX. 3 / 4 simple carpal scaphoid. There are hints of the scaphoid fracture.

RX. 3 / 4 extended carpal scaphoid. It clearly shows the fracture and a pocket above it.

The carpal scaphoid fracture, despite being "the lady in the tent," was not a major problem in treatment because he compiled a posterior plaster splint with an extension to the hand by paralysis of the radial, so the fist was always restrained.

The fracture consolidated, like the elbow, without necrosis. and the patient regained acceptable range of motion to do their jobs. It is now restored to their normal duties.

Total treatment time: 6 months.

Series of three photographs of the patient showing painless range of motion of the patient at 4 months of treatment.

Series of three photographs of the patient with free range of motion increased after 5 months of treatment.

Series of three photographs of the patient at 6 months of treatment. He was discharged on that date and was allowed to return to its normal work with some restrictions.

The patient is still recovering.