Unrecognized Isolated Medial Trochlear Fracture Leading to Malunion: A Case Report

Area of Science:

• Orthopedic Surgery
• Traumatology
• Medical Case Reports

Background:

• Intra-articular fractures of the elbow, particularly isolated trochlear fractures, are uncommon.
• Delayed diagnosis of traumatic elbow injuries can lead to malunion and significant functional deficits.

Purpose of the Study:

• To report a case of a missed intra-articular trochlear fracture with malunion.
• To highlight the importance of vigilant clinical examination in diagnosing uncommon elbow fractures.
• To demonstrate the efficacy of surgical management for malunited trochlear fractures.

Main Methods:

• Case presentation of a 20-year-old female with a delayed diagnosis of an isolated intra-articular trochlear fracture.
• Review of the initial presentation, delayed diagnosis, and subsequent surgical intervention.
• Description of the surgical technique: intra-articular osteotomy and anatomic fixation.

Main Results:

• The patient presented 12 weeks post-trauma with an anteriorly and superiorly displaced malunion of the medial trochlea.
• Severe range-of-motion restrictions of the elbow were noted due to the malunion.
• Surgical management with intra-articular osteotomy and anatomic fixation resulted in an excellent clinical outcome.

Conclusions:

• Missed intra-articular trochlear fractures can result in significant complications, including malunion and restricted elbow motion.
• Thorough clinical assessment is essential to prevent diagnostic delays in elbow trauma.
• Prompt surgical intervention, including osteotomy and anatomic fixation, can effectively treat malunited trochlear fractures and restore function.