Virtual fracture clinics: be vigilant for the ligamentous elbow injury.
Journal
Journal of surgical case reports
ISSN: 2042-8812
Titre abrégé: J Surg Case Rep
Pays: England
ID NLM: 101560169
Informations de publication
Date de publication:
Dec 2022
Dec 2022
Historique:
received:
13
11
2022
accepted:
27
11
2022
entrez:
21
12
2022
pubmed:
22
12
2022
medline:
22
12
2022
Statut:
epublish
Résumé
The Covid-19 pandemic encouraged remote healthcare and led to dependency on virtual fracture clinics (VFC). VFC are orthopaedic consultant-led clinics where cases are reviewed virtually following referral by emergency department clinicians. Success is contingent on a comprehensive initial history and examination. This pathway has high patient satisfaction rates and cost-saving benefits. However, clinicians must be vigilant for high-energy mechanisms or examination findings suggestive of greater underlying injury. In this case, VFC missed a rare ipsilateral annular ligament injury in a 15-year old with an undisplaced radial neck fracture, following a fall from a horse. This led to radial head dislocation and delayed surgical repair. Untreated, radial head dislocations lead to pain and reduced range of movement. Despite the rarity of this injury pattern, face-to-face orthopaedic examination would have raised concern for significant ligamentous injury. A high-energy mechanism of injury mandates face-to-face senior orthopaedic review to avoid missing serious concomitant injury.
Identifiants
pubmed: 36540296
doi: 10.1093/jscr/rjac587
pii: rjac587
pmc: PMC9760062
doi:
Types de publication
Case Reports
Langues
eng
Pagination
rjac587Informations de copyright
Published by Oxford University Press and JSCR Publishing Ltd. © The Author(s) 2022.
Références
J Shoulder Elbow Surg. 2014 Mar;23(3):297-301
pubmed: 24524978
Bone Joint J. 2013 Feb;95-B(2):151-9
pubmed: 23365021
EFORT Open Rev. 2020 Aug 1;5(7):442-448
pubmed: 32818071
J Child Orthop. 2021 Jun 01;15(3):186-193
pubmed: 34211594
Proc R Soc Med. 1977 Sep;70(9):620-4
pubmed: 918082