title: Traumatic pediatric olecranon injury: a report of suture fixation and review of the literature.
abstract: Elbow injuries make up to 3% to 4% of all emergency department presentations and are often difficult to diagnose. These injuries are often missed on radiographs because of the large cartilaginous component of the pediatric elbow resulting in malunion. Fractures around the elbow joint are one of the leading causes of litigation claim, and awareness of the pitfalls in diagnosis of these subtle injuries is necessary for a prompt diagnosis. Fracture of the olecranon epiphysis is rare and often being described around puberty and in association with osteogenesis imperfecta. Management using K-wire tension band fixation has been described in the past, which can lead to growth arrest in younger patients.We hereby present a missed rare sleeve-type open olecranon epiphyseal fracture in a young child, highlighting the pitfalls in the diagnosis of these injuries. This article also reviews various options to manage such a rare fracture and also suggests an alternative method of transosseous suture fixation with an excellent result.
authors.affiliation: Department of Paediatric Orthopaedics and Trauma, University Hospital of Wales, Cardiff, UK. rath.narendra@gmail.com
authors.forename: Narendra Kumar
authors.initials: NK
authors.lastname: Rath
authors.forename: Eleanor Clare
authors.initials: EC
authors.lastname: Carpenter
authors.forename: Daniel Phillip
authors.initials: DP
authors.lastname: Thomas
mesh_terms: D000058:Accidental Falls; D000273:Adipose Tissue / Q000000981:diagnostic imaging; D000900:Anti-Bacterial Agents; D002648:Child; D057210:Delayed Diagnosis; D003951:Diagnostic Errors; D004838:Epiphyses / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery; D005260:Female; D005547:Foreign Bodies / Q000000981:diagnostic imaging / Q000601:surgery; D005593:Fracture Fixation, Internal / Q000379:methods*; D005597:Fractures, Open / Q000000981:diagnostic imaging / Q000601:surgery*; D005898:Glass; D006801:Humans; D017746:Joint Capsule / Q000293:injuries / Q000601:surgery; D056740:Olecranon Process / Q000293:injuries* / Q000601:surgery; D011859:Radiography; D016059:Range of Motion, Articular; D020127:Recovery of Function; D013165:Splints; D013536:Suture Techniques; D014458:Ulna Fractures / Q000000981:diagnostic imaging / Q000601:surgery*
chemical_list: D000900:Anti-Bacterial Agents