Quick Tom J, Gibbons Paul, Smith Nick
Peripheral Nerve Injury Unit, Royal National Orthopaedic Hospital, London, UK.
J Pediatr Orthop B. 2013 Sep;22(5):481-5. doi: 10.1097/BPB.0b013e328361c856.
Elbow injuries in children are very common and radiographs are often difficult to interpret because of the radiolucency of the cartilaginous anlage and the progressive appearance of multiple secondary ossification centres. Elbow dislocations are rare injuries in children. Coronoid fractures can occur during dislocation or relocation of the elbow and can be the only hallmark of a severe injury. The understanding of the mechanics of these injuries has undergone considerable evolution over the past decade. Intra-articular chondral flap fractures are a traumatic elevation of the hyaline cartilage from the subchondral bone. They are also rare injuries in children but should be included in the differential when examining an injured joint. The infrequency of these injuries provides little opportunity to become accustomed to the radiographic signs. We present a case report of a 4-year-old boy with both an olecranon chondral flap and coronoid cartilaginous fracture after a joint dislocation. We present his plain radiography and MRI with illustrated photographic records of the operative findings. This injury has been little described in the literature and never with such imaging to aid understanding of both the pathology and the injury mechanism.
儿童肘部损伤非常常见，由于软骨原基的透X线性以及多个继发骨化中心的逐渐出现，X线片常常难以解读。儿童肘关节脱位是罕见损伤。冠状突骨折可发生于肘关节脱位或复位过程中，且可能是严重损伤的唯一标志。在过去十年中，对这些损伤机制的认识有了相当大的发展。关节内软骨瓣骨折是透明软骨从软骨下骨的创伤性抬高。它们在儿童中也是罕见损伤，但在检查受伤关节时应列入鉴别诊断。这些损伤的罕见性使得很少有机会熟悉其影像学表现。我们报告一例4岁男孩，关节脱位后同时发生鹰嘴软骨瓣和冠状突软骨骨折。我们展示了他的X线平片和MRI，并配有手术所见的图示照片记录。这种损伤在文献中很少被描述，且从未有过这样的影像学资料来辅助理解其病理和损伤机制。
