Isolated fracture of the humeral trochlea: a case report and review of the literature

Abstract

INTRODUCTION: Isolated fracture of the trochlea is a rarely reported entity. To the best of our knowledge, only 15 cases have been published. We report the case of a patient with an isolated fracture of the trochlea and discuss through a literature review the underlying mechanisms and the clinical, radiological and therapeutic features of this lesion. This work will significantly advance our understanding of this particular fracture. CASE PRESENTATION: A 21-year-old Caucasian man received an elbow injury. An anteroposterior radiograph showed only an irregularity of the medial joint space, but a lateral radiograph showed an intra-articular half-moon-shaped fragment that had moved up and forward. A computed tomography scan confirmed an isolated fracture of his trochlea. Open reduction and internal fixation were performed with a good outcome. CONCLUSION: An isolated fracture of the trochlea is rare. The mechanisms generating this fracture are complex. As with other front-line fractures of the distal end of the humerus, such as the capitulum, we recommend open reduction and internal fixation for displaced fractures, with excision of the small osteochondral fragments that do not permit any osteosynthetic repair.