Isolated pediatric transolecranon fracture‐dislocation of the elbow managed nonoperatively: A case report and review of literature

Abstract

We report on the sixth case of an isolated pediatric transolecranon fracture‐dislocation, and the first case utilizing nonoperative management in a cast following closed reduction resulting in an excellent outcome. Our case provides support for nonoperative management of these rare injuries, especially when surgery is not practical or desirable.

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.…”

“…Previous cases of pediatric transolecranon fracture dislocations have been treated with either a tension band wiring using Kirschner wires or plate fixation. 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.…”

“… 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.…”

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

“…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] . In the limited reports of these injuries, all but one patient underwent ORIF, and patients who underwent delayed surgery experienced longer operative times 6 .…”

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

“…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 ]. We fixed the olecranon fracture with two crossing bicortical 1.5 mm K-wires because in our opinion a k-wire fixation is sufficient for treating a pediatric olecranon fracture avulsion especially in very young children.…”