Humeral Head Fracture with Intrathoracic Migration

Abstract

Fracture-dislocation of the humeral head with intrathoracic migration is extremely rare. In our study we describe the case of a 23-year-old man who was admitted to the emergency clinic of our hospital, after being injured in a high-speed motor vehicle accident. The patient presented in a state of hemorrhagic shock and severe respiratory disease. Chest radiography showed fracture of the right humeral head and the presence of a round radio-density area resting on the diaphragm right hemithorax. The total body computed tomography scan revealed a right pneumothorax related to the presence in the chest cavity of the fractured humeral head, longitudinal fracture of the sacrum, and diastasis of the symphysis pubis. After an initial hemodynamic stabilization the patient underwent surgical excision of the humeral head and its replanting. It is important after airway management and the use of diagnostic imaging, the treatment of any injuries associated with the trauma. 摘要: 向胸腔內移位的肱骨頭骨折脫臼是極為罕見的。我們報告了一名23歲男子，因高速交通意外被送往我們醫院的急診室。病人呈現出血性休克和嚴重的呼吸道疾病的狀態。胸部X光檢查顯示右側肱骨頭骨折，以及在右邊半胸橫隔膜上有一個圓形不透X光的影像。全身電腦掃描顯示病人因肱骨頭移到胸腔，引致右氣胸;有骶骨的縱向骨折;以及恥骨結合位擴張。在病人初步穩定後，我們為他進行手術取回移位的肱骨頭，用螺釘內固定。我們討論了當中的治療，前景，和文獻綜述。 Keywords: humeral head fracture, intrathoracic migration, trauma