Journal List > J Korean Soc Surg Hand > v.21(3) > 1106528

J Korean Soc Surg Hand. 2016 Sep;21(3):152-156. Korean.
Published online September 29, 2016.  https://doi.org/10.12790/jkssh.2016.21.3.152
Copyright © 2016. The Korean Society for Surgery of the Hand
Isolated Fracture of Distal Humeral Trochlea
Ki-Won Lee, Joo-Yul Bae, Hyung-Kwon Cho and Hee-Jae Won
Department of Orthopedic Surgery, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea.

Correspondence to: Joo-Yul Bae. Department of Orthopedic Surgery, Gangneung Asan Hospital, University of Ulsan College of Medicine, 38 Bangdong-gil, Gangneung 25440, Korea. TEL: +82-33-610-3249, FAX: +82-33-641-8050, Email: qwonduf@hanmail.net
Received March 02, 2016; Revised July 11, 2016; Accepted July 12, 2016.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Abstract

Isolated fracture of the distal humeral trochlea occurs while the axial load delivered to the elbow passes through the trochlear of the distal humerus. It has been rarely reported, because of those reasons. The trochlea is located deep inside of the elbow joint space and since it does not have the direct attachment with muscles or ligaments, a force is hardly transmitted directly. Also ulno-humeral joint is less influenced by compressive or shear force than radio-humeral joint. We report a case of isolated trochlear fracture with review of the literature.

Keywords: Humerus; Trochlea; Fracture

Figures


Fig. 1
Initial radiograph.
Click for larger image


Fig. 2
(A, B) Initial computed tomography scan.
Click for larger image


Fig. 3
(A, B) Postoperative radiograph and sagittal plane views of computed tomography scan shows open reduction and internal fixation with cancellous screw.
Click for larger image


Fig. 4
Radiograph after implant removal.
Click for larger image

Tables


Table 1
Reports of isolated trochlear fracture
Click for larger image

References
1. Foulk DA, Robertson PA, Timmerman LA. Fracture of the trochlea. J Orthop Trauma 1995;9:530–532.
2. Sen RK, Tripahty SK, Goyal T, Aggarwal S. Coronal shear fracture of the humeral trochlea. J Orthop Surg (Hong Kong) 2013;21:82–86.
3. Abbassi N, Abdeljaouad N, Daoudi A, Yacoubi H. Isolated fracture of the humeral trochlea: a case report and review of the literature. J Med Case Rep 2015;9:121.
4. Park JH, Kim JH, Lee JH, Cha SD, Yoo JH. Isolated fracture of the trochlea in humerus: a case report. J Korean Soc Surg Hand 2006;11:197–200.
5. Kwan MK, Khoo EH, Chua YP, Mansor A. Isolated displaced fracture of humeral trochlea: a report of two rare cases. Injury Extra 2007;38:461–465.
6. Gomati A, Domos P, Crossman P. Delayed surgical management of an isolated trochlear fracture of the elbow. Ann R Coll Surg Engl 2016;98:e31–e33.
7. Lechasseur B, Laflamme M, Leclerc A, Bedard AM. Incipient malunion of an isolated humeral trochlea fracture treated with an elbow hemiarthroplasty: case report. J Hand Surg Am 2015;40:271–275.
8. Worrell RV. Isolated, displaced fracture of the trochlea. N Y State J Med 1971;71:2314–2315.
9. Goncalves LB, Ring DC. Fractures of the humeral trochlea: case presentations and review. J Shoulder Elbow Surg 2016;25:e151–e155.
10. Dubberley JH, Faber KJ, Macdermid JC, Patterson SD, King GJ. Outcome after open reduction and internal fixation of capitellar and trochlear fractures. J Bone Joint Surg Am 2006;88:46–54.