Anterior transolecranon dislocation of the elbow in a child: A case report and review of literature

Abstract

Anterior transolecranon dislocation of the elbow is rarely observed in children, reported in only a small series. The present case involves an anterior transolecranon dislocation of the left elbow joint in a 7-year-old child, which was surgically treated. Two attempts of closed reduction failed because the radial head had buttonholed via the joint capsule. After its release, open reduction was easily performed; osteosynthesis of the olecranon was not performed. Remarkably, good result was obtained, despite a mild flexion deformity at the last follow-up. This case report aims to highlight this treatment method, which may be considered for such an uncommon injury.

Anterior trans-olecranial dislocation of the elbow in children: A case report of an unusual form of elbow dislocation and review of literature

“…Most of authors advocate open reduction and internal fixation, however closed reduction when possible, yielded excellent results as stated by Tiemdoj et al [10] . Internal fixation was not necessary in the case reported by Bouaziz et al [14] where after open reduction the elbow was found to be stable and no fixation for the olecranon was used with only a stabilization with a long arm splint.…”

Anterior transolecranon fracture dislocation with an associated avulsion fracture of coronoid process of ulna in a child: a case report

“… 13 However, coronoid process fractures have not been observed in children with this injury pattern in 11 cases in previous reports. 2 , 3 , 5 , 8 , 15 , 17 In the previous 11 cases of this injury, 1 case was associated with an avulsion fracture of the medial epicondyle, and 1 case was associated with radial neck fracture. The other 7 cases were isolated anterior transolecranon fracture dislocations.…”

“… 5 , 8 , 17 Arain et al 2 and Tiemdio et al 15 reported treating this injury with nonoperative management in a cast after closed reduction. Bouaziz et al 3 reported that open reduction was required because the radial head had buttonholed via the joint capsule. Internal fixation was not performed in this case.…”

“… 8 To our knowledge, only 11 cases of transolecranon fracture variants have been reported in literature. 2 , 3 , 8 , 13 , 15 , 17 Transolecranon fracture dislocation resembles an anterior Monteggia lesion because the radial head dislocates anterior to the capitellum. However, the proximal radioulnar joint remains aligned and intact in transolecranon fracture dislocations, which differ from Monteggia-type fracture dislocations.…”

Pediatric trans-olecranon fracture dislocation of the elbow associated with fracture of the radial head and with medial collateral ligament lesion: A case report and review of the literature

“…H. Tiemdjo et al in 2015 propose a classification into four types of anterior trans-olecranon fracture-dislocations of the elbow in children, thereby guiding surgical indications [ 6 ]. Traditionally the management of this fracture has been surgical with tension band construct in avulsions and transverse fractures [ 7 , 8 ] and bone plate in oblique fractures in older children. Some Authors reported a nonsurgical management of trans-olecranon fracture dislocation in children with good results [ 9 ].…”