A Rare Case of Isolated Intra-Articular Fracture of Humeral Trochlea: Surgical Management by Posterior Approach

Abstract

Introduction: Isolated fracture of the trochlea is rare and is only recorded few times in literature and the surgical management by posterior approach is never described. The rare incidence may be attributed to its position deep inside the elbow joint without any tendinous or ligamentous attachment, thus protected from any injury. Aim: Our aim is to ascertain the significance of posterior approach to the elbow with Chevron’s osteotomy in adequate reduction of isolated humeral trochlear fractures. Case: We report a rare case of fracture of trochlea in a 20-year-old male and its surgical management by posterior approach with Chevron’s olecranon osteotomy and also describe the advantages and disadvantages of the approach over medial and anterior approaches. Functional outcome at two-year follow-up was satisfactory without any complications. Conclusion: Posterior approach of elbow with Chevron’s osteotomy can be used for isolated fractures of humeral trochlea as it provides adequate exposure and for visualization and instrumentation along with protection of important neurovascular structures.