Xiang Ren, Qingsong Tang, Kang Zhao, Jie Hu
Department of Orthopedics, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China.
Front Surg. 2025 Aug 5;12:1487129. doi: 10.3389/fsurg.2025.1487129. eCollection 2025.
Dislocations of the elbow are not common in skeletally immature patients. Herein, we present a case report on a rare pediatric posterior trans-olecranon fracture dislocation of the elbow, a type of dislocation that has never been reported in children. We aim to discuss the injury mechanism and introduce our treatment approach for this specific condition.
A ten-year-old girl presented with pain, swelling and deformity of the left elbow following a fall from a rocking chair.
The complete injury history and detailed physical examination were recorded. Radiographs revealed fractures affecting the coronoid process of the ulna, olecranon of the ulna, radial neck, along with dislocation of radiocapitellar joint, and posterior medial displacement of proximal radial-ulnar joint. Based on these findings, the diagnosis of posterior trans-olecranon fracture dislocation of the elbow was made. To restore stability of the elbow, open reduction and internal fixation were performed. This involved securing the coronoid process of the ulna with the suture lasso technique and stabilizing the olecranon of the ulna with two 2.0 mm Kirschner wires inserted into the medullary cavity. The wires were subsequently removed at 2 months postoperatively.
Three months after the initial surgery, which is one month after the removal of internal fixation, the affected elbow joint achieved a range of motion of 140° flexion and 0° extension, with no limitation in forearm rotation activities. The elbow joint was stable and painless during movement. At the one-year follow-up, no difference was observed in the function of the bilateral elbow joints, and imaging examinations showed normal anatomical relationships of the elbow joints.
This specific type of injury, termed as posterior trans-olecranon fracture-dislocation of the elbow, is rare and has few reports in the pediatric population. We, hereby, report the case to emphasize the importance of promptly restoring the stability of the elbow and initiating early actively range-of-motion exercises to ensure a favorable outcome.
肘关节脱位在骨骼未成熟的患者中并不常见。在此，我们报告一例罕见的儿童肘关节经鹰嘴后骨折脱位病例，这种脱位类型在儿童中从未有过报道。我们旨在探讨损伤机制并介绍针对这种特殊情况的治疗方法。
一名10岁女孩在从摇椅上跌落之后，出现左肘部疼痛、肿胀和畸形。
记录了完整的受伤史并进行了详细的体格检查。X线片显示尺骨冠状突、尺骨鹰嘴、桡骨颈骨折，桡骨头关节脱位，以及桡尺近端关节后内侧移位。基于这些发现，诊断为肘关节经鹰嘴后骨折脱位。为恢复肘关节稳定性，进行了切开复位内固定。这包括用缝线套索技术固定尺骨冠状突，并用两根2.0毫米克氏针插入髓腔来稳定尺骨鹰嘴。术后2个月取出克氏针。
初次手术后3个月，即内固定取出后1个月，患侧肘关节屈伸活动范围达到140°屈曲和0°伸展，前臂旋转活动不受限。肘关节在活动时稳定且无痛。在1年随访时，双侧肘关节功能无差异，影像学检查显示肘关节解剖关系正常。
这种特殊类型的损伤，即肘关节经鹰嘴后骨折脱位，较为罕见，在儿童人群中的报道很少。我们特此报告该病例，以强调及时恢复肘关节稳定性并尽早开始积极的活动范围锻炼以确保良好预后的重要性。
