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Abstract
This report was designed to investigate a rare case that brachialis tear and hematoma caused by acute elbow posterior dislocation. We studied a 20-year-old male patient with right elbow joint pain after outstretched injury. Physical examination showed instability of hright elbow joint and simple radiography indicated a posterolateral dislocation of right elbow joint. Computed tomography taken after closed reduction using Parvin technique revealed a few small bone fragment located on posterior humerus capitulum. Magnetic resonance imaging showed complete tear of brachialis and anterior articular capsule with hematoma. The patient was managed with long arm splint and hinge brace for an elbow dislocation with brachialis rupture and hematoma. The elbow joint range of motion was recovered to be in a normal range, and pain was diminished. There are few reported cases of acute elbow posterior dislocation combined with brachialis rupture and hematoma. The patient showed good clinical outcome after conservative treatment.
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Fig. 1.
In plain X-ray, there is no definite fracture line at right elbow, but shows posterolateral elbow dislocation.
Fig. 2.
In computed tomography view, small bony fragment is detected posterior to the right humerus capitulum.
Fig. 3.
(A, B) In right elbow magnetic resonance imaging sagittal view, there is high signal change in ant. articular capsule and brachialis all layers. Also in axial view, it shows hematoma in brachilalis muscle and emptying sign on ligament attachment site.
Fig. 4.
In the magnetic resonance imaging sagittal view which took after a month from the event, it shows reduced hematoma and decreased signal changes around brachilalis muscle compare to previous film.
Fig. 5.
In the magnetic resonance imaging sagittal view which took after 3 month from the event it shows removed hematoma and more decreased signal changes around brachilalis muscle compare to previous film.
Table 1.
Mechanism of event and prognosis, and therapeutic method in case reports of rupture of brachialis
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