Quintero Cabrera Nicolas O, Castellanos Mendoza Cristal J, Rojas Lievano Jorge L, Cardona Ortegón Jose D, Pedraza Yepes Jaime A
Department of Orthopedics and Traumatology, University Hospital Fundación Santa Fe de Bogotá, Bogotá, COL.
Department of Radiology, University Hospital Fundación Santa Fé de Bogotá, Bogotá, COL.
Cureus. 2023 Sep 5;15(9):e44706. doi: 10.7759/cureus.44706. eCollection 2023 Sep.
Fractures of the lateral condyle and olecranon are two of the most common elbow injuries in the pediatric age group. However, their simultaneous occurrence is rare. Proper understanding and management of these injuries are essential to prevent long-term complications. This case report presents a patient who suffered both fractures, with surgical intervention for the condyle and non-surgical management for the olecranon. A two-year-old female child was brought to the emergency department following a fall from monkey bars, landing on her outstretched left arm. Clinical examination showed a markedly swollen and tender elbow with a restricted range of motion. No neurovascular deficit was noted. Plain radiographs revealed a displaced fracture of the lateral condyle and an associated non-displaced olecranon fracture. Given the displacement of the lateral condyle fracture, surgical intervention was deemed necessary. The patient underwent open reduction and internal fixation (ORIF) of the lateral condyle using Kirschner wires. The olecranon fracture, being non-displaced, was managed conservatively with a posterior splint. The patient's postoperative recovery was uneventful. The Kirschner wires were removed at six weeks of follow-up, and active mobilization was started. The patient achieved full range of motion at three months post-injury. At a one-year follow-up, she had no pain, restriction, or any deformity, and radiographs confirmed the complete union of both fractures. Simultaneous fractures of the lateral condyle and olecranon in children are rare. The mechanism of injury is complex and warrants a high index of suspicion for associated injuries. Surgical fixation of the lateral condyle and conservative management of the olecranon fracture can yield excellent outcomes.
外侧髁和鹰嘴骨折是小儿年龄组中最常见的两种肘部损伤。然而，它们同时发生的情况很少见。正确理解和处理这些损伤对于预防长期并发症至关重要。本病例报告介绍了一名同时患有这两种骨折的患者，其中外侧髁骨折接受了手术干预，鹰嘴骨折采取了非手术治疗。一名两岁女童从猴架上跌落，左臂伸直着地后被送往急诊科。临床检查发现肘部明显肿胀、压痛，活动范围受限。未发现神经血管缺损。X线平片显示外侧髁骨折移位，伴有鹰嘴骨折无移位。鉴于外侧髁骨折移位，认为有必要进行手术干预。患者接受了使用克氏针的外侧髁切开复位内固定术（ORIF）。鹰嘴骨折无移位，采用后侧夹板保守治疗。患者术后恢复顺利。随访六周时取出克氏针，并开始主动活动。患者在受伤后三个月达到了全关节活动范围。在一年的随访中，她没有疼痛、活动受限或任何畸形，X线片证实两处骨折均已完全愈合。儿童外侧髁和鹰嘴同时骨折很少见。损伤机制复杂，需要高度怀疑是否存在相关损伤。外侧髁的手术固定和鹰嘴骨折的保守治疗可取得良好效果。
