A pediatric terrible triad fracture of elbow with lateral epicondyle avulsion.

Trauma Case Rep

Department of Pediatric Orthopedic and Traumatology, University Hospital Hassan II, Sidi Mohamed Ben Abdellah University, The Faculty of Medicine and Pharmacy of Fez, Boite Postale 1893 - KM 2.200 Route, Sidi Harazem Fès 30070, Morocco.

Published: August 2024

AI Article Synopsis

  • A terrible triad fracture of the elbow includes an elbow dislocation along with fractures of the coronoid process and radial head, which are rare in adults and even more so in children.
  • A case involving a 14-year-old boy was diagnosed through X-ray and confirmed with a CT scan after a closed reduction revealed an unstable elbow.
  • In surgery, the radial head and lateral epicondyle were fixed using K-wire, and the coronoid process was secured, leading to good clinical outcomes after two years, emphasizing the need for a CT scan post-reduction in such cases.

Article Abstract

A terrible triad fracture of the elbow is defined as an elbow dislocation with associated fractures of the coronoid process and radial head. This injury is uncommon in adults and exceptional in immature skeletons. We report a rare case of a terrible triad in a 14-year-old boy with a lateral epicondyle fracture. The diagnosis was suspected by the X-ray and confirmed by a CT scan after a closed reduction of the elbow, which was unstable. After a lateral approach of the elbow, the radial head and the lateral epicondyle were fixed by K-wire, and the fragment of the coronoid process was fixed by a bone suture. At two years of follow-up, the clinical and radiological outcomes were good. The terrible triad of the elbow is an exceptional trauma in children. Fracture avulsion of the lateral epicondyle is a particularity in the immature skeleton, equivalent to the lateral ligament injury in adults. A CT scan is mandatory after the reduction of the elbow to evaluate bone lesions. Open reduction by a single-lateral approach is indicated in cases of instability in extension.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11109867PMC
http://dx.doi.org/10.1016/j.tcr.2024.101036DOI Listing

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