Isolated trochlea and triquetrum fractures in an immunocompromised adolescent after a ground-level fall

Isolated fractures of the humeral trochlea and triquetral avulsion fractures are uncommon, and to our knowledge, there are no reported cases of these two injuries occurring simultaneously (deleted). Thorough physical examination and advanced imaging facilitate diagnosis and guide fixation. Immunosuppressive therapy, such as chronic prednisone and tacrolimus, has the potential to predispose patients of all ages to uncharacteristic injury patterns. These cases may require a more focused initial work-up. Surgeons should maintain a high index of suspicion for atypical patterns in immunosuppressed individuals despite seemingly benign mechanisms of injury. We describe an adolescent male with concomitant ipsilateral isolated trochlear and triquetral avulsion fractures discovered after a ground-level fall while on chronic immunosuppressive therapy.