Missed Jeffery Type II Injury: Treatment in Two Cases and Literature Review

The diagnosis and management of Type 2 Jeffery injuries, particularly when missed in the acute phase, present significant challenges. There are few documented cases of Jeffery fractures in the literature, and limited evidence regarding outcomes following treatment of delayed or missed injuries. We present two cases of undiagnosed Jeffrey Type 2 lesions. Both patients, aged 10 and 8 years, initially presented with elbow pain after falls. The injuries were unrecognised at initial assessment, but were identified at follow-up 3-4 weeks later. Surgery was performed promptly after diagnosis. In both cases, the postoperative results included full flexion-extension of the elbow, but residual limitations in supination and pronation were observed. Long-term follow-up showed gradual improvement in range of motion, although mild deficits persisted. In the context of acute elbow dislocation in childhood, the recognition of concomitant Jeffery's injury is of paramount importance given the potential for significant morbidity and the need for prompt intervention. Open reduction with soft tissue reconstruction and osteosynthesis of the fracture can be an effective treatment, providing satisfactory long-term clinical and radiographic results, even in cases where the fracture was initially missed. Systematic radiographic assessment of paediatric elbow injuries is therefore essential to avoid misdiagnosis and ensure optimal treatment.