[The traffic elbow. A series of 9 cases].
"Traffic elbow" is a condition occurring when high energy trauma involves a patient's elbow resting on the window of the car or completely outside it. This is a prospective study over 30 months of 9 patients with "traffic elbow" and therefore sufferring complex open trauma to the elbow. There were 8 men and 1 woman with a median delay of 4 hours before arrival in hospital. The dominant member was affected in 3 cases. The severity of the lesions, using the Mangled Extremity Severity Score (MESS), was more than 7, comprising lesions corresponding to type 1 of the complex trauma of the superior member (TCMS) in 2 patients and a MESS score of between 3 and 6 corresponding to types 2 or 3 of the TCMS for the other 7 patients. The therapeutic possibilities are limited considering the frequent context of polytrauma. In 4 cases we performed a debridement and external humero-ulnar fixation, in 3 cases a debridement and stabilization with Kirschner's wires completed by a fenestrated cast, and in 2 cases a lifesaving amputation. All patients, except those that had had amputation, developed deep sepsis that resolved after adequate treatment. Assessment of the non-amputee patients according to the Mayo Performance Score, yielded more than 70% of bad results. The authors stress the gravity of these lesions whose prognosis is guarded both concerning mobility of the elbow and the frequent neurovascular complications.
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Service d'orthopédie-traumatologie, hôpital Aristide-Le-Dantec, BP 10374, Dakar-Liberté, Sénégal. danielsane@hotmail.com
Ndaw
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Diémé
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Coulibaly-Ndiaye
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Ndiaye
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Sy
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Mbaye
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B
Sèye
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SI
D000063:Accidents, Traffic; D000328:Adult; D000671:Amputation, Surgical; D002370:Casts, Surgical; D003646:Debridement; D004550:Elbow / Q000601:surgery*; D005260:Female; D005592:Fracture Fixation; D006801:Humans; D006810:Humeral Fractures / Q000601:surgery; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014458:Ulna Fractures / Q000601:surgery; D000092464:Elbow Injuries