Department of Orthopaedics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
JBJS Case Connect. 2022 Apr 6;12(2):01709767-202206000-00005. doi: e22.00015.
A 7-year-old girl sustained a radiographic appearance seemed harmless (TRASH) elbow lesion after falling from play equipment. Initial radiographs demonstrated a transolecranon fracture-dislocation. Additional injury was suspected, given valgus instability after reduction. Subsequent magnetic resonance imaging (MRI) revealed a large osteochondral coronoid fragment only partially visible on initial radiographs and computed tomography (CT). Successful outcomes were achieved by ulnar nerve decompression, open reduction, and fixation.
TRASH lesions, including this osteochondral coronoid injury, may be overlooked in younger children because of an abundance of unossified cartilage. A high index of suspicion and early MRI can lead to successful diagnosis and treatment.
一名 7 岁女孩从游乐设备上摔下后，肘部出现看似无害（TRASH）的影像学损伤。最初的 X 线片显示为鹰嘴骨折脱位。复位后出现外翻不稳定，提示存在其他损伤。随后的磁共振成像（MRI）显示冠状突有大块的骨软骨骨折碎片，最初的 X 线片仅部分可见，计算机断层扫描（CT）也可见。通过尺神经减压、切开复位和固定，获得了满意的结果。
TRASH 损伤，包括这种骨软骨冠状突损伤，由于存在大量未骨化的软骨，在年龄较小的儿童中可能被忽视。高度怀疑和早期 MRI 有助于做出正确的诊断和治疗。
