Miskend letsel van de elleboog bij een ipsilaterale proximale humerusfractuur


Dit case report beschrijft de casus van twee patiënten met een fractuur van de proximale humerus, waarbij in eerste instantie traumatisch letsel van de ipsilaterale elleboog is gemist. In casus 1 betreft dit een terrible triad van de elleboog, waarbij de uiteindelijke behandeling een totale elleboogartroplastiek is. In casus 2 is een olecranonfractuur miskend, wat heeft geleid tot een milde extensiebeperking die geen behandeling behoeft. Miskenning van letsel van de elleboog bij een fractuur van de proximale humerus kan worden voorkomen met behulp van de elleboogextensietest, die snel en eenvoudig is af te nemen. Indien de patiënt zijn elleboog niet volledig actief kan strekken, is aanvullend röntgenonderzoek noodzakelijk. Hiermee kan blijvende schade en functionele beperking van de elleboog worden voorkomen.


This case report describes the cases of two patients with a fracture of the proximal humerus in which concomitant traumatic injury of the ipsilateral elbow failed to be diagnosed. In case 1 a terrible triad of the elbow was initially not recognized, wherefore the final treatment was a total elbow arthroplasty. In case 2 an olecranon fracture was missed, which lead to a mild extension deficit, that needed no further treatment. In order to recognize a combined shoulder-elbow injury in patients with a proximal humerus fracture, the elbow extension test is a simple and reliable test. A radiograph is indicated when the patient is unable to fully extend his elbow. Hereby, it is possible to prevent irreversible damage and functional limitation of the elbow joint.

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Correspondence to T. Kraal.

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anios Spoedeisende Hulp, Kennemer Gasthuis (voorheen coassistent Orthopedie, Medisch Centrum Alkmaar)

orthopedisch chirurg, afdeling Orthopedische Chirurgie, Medisch Centrum Alkmaar

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Kraal, T., Keijser, L.C.M. Miskend letsel van de elleboog bij een ipsilaterale proximale humerusfractuur. TVTR 18, 110–116 (2010). https://doi.org/10.1007/BF03089829

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