65-year-old obese woman who suffers a fall on her hand with her elbow in extension. She presents with arm pain with swelling and functional impotence of the arm and inability to extend the wrist and fingers. It is most likely to present:
We must take into account all the clinical data provided: after trauma we have pain in the arm with soft tissue involvement and the impossibility of extending the wrist and fingers. The only option that includes all the data is 4. Option 1 does not explain the involvement of the wrist and fingers. The elbow dislocation does not explain the lack of finger mobility as well as the diaphyseal fracture of the humerus and double forearm. "Direct mechanism is possible, as is indirect transmission of forces from the elbow and hand...radial nerve involvement is extremely frequent, reaching an incidence of 10-18% of cases." Proximal humerus fracture-dislocation would have greater involvement at the shoulder, elbow dislocation at the elbow, and there is no data to suggest double forearm fracture.
Dislocation fracture of proximal humerus.
Elbow dislocation.
Diaphyseal fracture of the humerus associated with double forearm fracture.
Diaphyseal fracture of humerus with radial nerve injury.
Option 1 does not explain the involvement of the wrist and fingers.
The elbow dislocation does not explain the lack of finger mobility as well as the diaphyseal fracture of the humerus and double forearm.
Proximal humerus fracture-dislocation would have greater involvement at the shoulder, elbow dislocation at the elbow, and there is no data to suggest double forearm fracture.
after trauma we have pain in the arm with soft tissue involvement and the impossibility of extending the wrist and fingers. The only option that includes all the data is 4.