"TRASH" Transolecranon Fracture-Dislocation with Occult Osteochondral Coronoid Fracture: A Case Report. Issue 2 (6th April 2022)

• Record Type: Journal Article
• Authors: Zheng, Jenny L.; Shah, Apurva S.; Nguyen, Jie; Baldwin, Keith D.
• Is Part Of: JBJS case connector. Volume 12:Issue 2(2022)
• Publication Date: 2022-04-06
• Subjects: pediatrics -- trauma -- elbow -- upper extremity -- olecranon -- coronoid -- fracture -- dislocation -- surgical treatment -- surgery -- TRASH -- elbow lesion -- MRI -- CT -- ulnar nerve -- chondral -- osteochondral -- unossified cartilage; Orthopedic surgery -- Case studies -- Periodicals; Orthopedic surgery -- Periodicals; Orthopedics; Orthopedic Procedures; Orthopedic surgery; Periodicals; Electronic journals; Case studies; Periodicals; 616.7
• DOI: 10.2106/JBJS.CC.22.00015
• Languages: English
• ISSNs: 2160-3251

Abstract

Abstract : Case: 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. Conclusion: 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.