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

Abstract

Introduction We report what is, to the best of our knowledge, the first case of pediatric trans-olecranon fracture dislocation of the elbow associated with a radial head fracture and with a medial collateral ligament disruption. Case presentation A 7-year-old girl presented to the emergency department after a fell on his right elbow while playful activity at home. The elbow X-ray showed acute trans-olecranon fracture dislocation of the elbow associated with a radial head fracture. A pre-operative 3D TC scans confirmed and clarified the injury pattern. However, stress radiographs performed in the operating room under anesthesia revealed an associated severe valgus instability caused by medial collateral ligament disruption. The olecranon fracture was fixed with two crossing 1.5 mm K-wires and the angulated radial neck fracture was fixed with a retrograde 1.5 mm K-wire by S.E.R.I. technique. Conclusion Although trans-olecranon fracture dislocation of the elbow is well recognized and clearly described in adults, it is uncommon in children. A pre-operative 3D TC scans are recommended to enable a more accurate diagnosis and surgical planning. Medial collateral ligament has a central role in elbow stability and is very important to repair it during surgery.

“TRASH” Transolecranon Fracture-Dislocation with Occult Osteochondral Coronoid Fracture

“…T RASH lesions, including the transolecranon fracturedislocation with an osteochondral coronoid fracture presented here, are relatively rare injuries that are difficult to identify on initial examination and can therefore be challenging to diagnose and treat. Subsequently, management of these fractures is ill-defined in the existing literature 5 . To the best of our knowledge, only 12 cases of pediatric transolecranon fracture-dislocations have been reported, only one of which presented concurrently with a coronoid fracture, although the dislocation was already relocated at presentation [6][7][8] .…”

CORHD Lesions: A New Pediatric Terrible Triad of the Elbow. A Case Report and Literature Review

“…TRASH lesions are relatively rare and difficult to identify at the initial examination. The management of these fractures is not well defined in the existing literature [1]. Imaging should be used to better visualize fracture fragments, establish a more accurate diagnosis and guide surgical strategy.…”