Arch Hand Microsurg.  2019 Sep;24(3):243-247. 10.12790/ahm.2019.24.3.243.

Importance of Magnetic Resonance Imaging Examination in Unossified Avulsion Fracture of Child Elbow

• Oh BH
• Kim TK
• Heo YM
• Cha HJ

• KMID: 2456248
• DOI: http://doi.org/10.12790/ahm.2019.24.3.243

Abstract

Unossified elbow avulsion fractures of children should be treated with care. Simple avulsion fractures seen on an x-ray may actually be severe injuries such as elbow joint subluxation or radial head dislocation. So, definite diagnosis is important in determining appropriate treatment of avulsion fractures around the unossified elbow, and magnetic resonance imaging (MRI) examination plays a key role in the diagnosis. We experienced avulsion fracture of the capitulum with common extensor tendon and lateral collateral ligament injuries and ulnar coronoid process fracture in an 11-year-old boy and radial head dislocation with common flexor tendon and partial ulnar collateral ligament injuries in an 8-year-old boy. We would like to talk about the importance of MRI in unossified avulsion fracture of child elbow by reviewing 2 case reports.

Keyword

Radial head; Elbow; Avulsion fracture

MeSH Terms

Child*
Collateral Ligaments
Diagnosis
Dislocations
Elbow Joint
Elbow*
Head
Humans
Lateral Ligament, Ankle
Magnetic Resonance Imaging*
Male
Tendons

Figure

• 

  Fig. 1 Initial (A) anteroposterior and (B) oblique plain radiographs showed a right ulnar coronoid process fracture (arrows in A and B) and (C) anteroposterior and (D) oblique plain radiographs show the opposite side. (E) Magnetic resonance imaging showed radial head subluxation (arrow) with lateral collateral ligament injury. (F) Magnetic resonance imaging showed capitulum fracture (arrow) with common extensor tendon and collateral ligament injuries. (G) In gross photo, common extensor tendon and lateral collateral ligament were injured. (H), (I), and (J) plain radiographs taken after operation and in one, four month, respectively.

• 

  Fig. 2 Initial (A) anteroposterior (arrow) and (B) lateral radiograph of left elbow showed a bony fragment around the radial head. (C) and (D) magnetic resonance imaging showed a fracture with epiphyseal separation of radial head and neck (arrow at right lower in C and D) along with a partial tear of ulnar collateral ligament (arrow at left upper in C). (E) Radial head was completely dislocated and (F) reduced. (G) In postoperative radiograph, dislocated bony fragment was located on arrow. (H) After 1 month from operation, plan radiograph was taken. (I) After 5 months from operation, plan radiograph was taken.

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