Bioabsorbable fixation of a pediatric trochlear notch chondral injury

An 8-year-old girl fell onto her outstretched arm, sustaining proximal ulna and radial neck fractures. After closed reduction and casting in the emergency department, radiographs showed improved alignment but limited bony detail. A CT scan performed 3 days later demonstrated 18° apex-medial angulation of the radial neck, slight radiocapitellar subluxation, and subtle calcification near the trochlear notch, concerning intra-articular injury. Surgical exploration revealed a large cartilaginous shear fracture of the trochlear notch involving the coronoid. The fragment was anatomically reduced and fixed with bioabsorbable chondral fixation darts, and the olecranon was stabilized using Kirschner wires and a tension-band construct. Early follow-up demonstrated a functional range of motion without pain. Chondral shear injuries of the trochlear notch in children are rare lesions. Early recognition and fixation can restore joint congruity and function. Bioabsorbable implants offer a viable solution, even when the subchondral bone is minimal.