Kettering General Hospital

Title: Paediatric triceps avulsion fracture identified with ultrasound


Dr. VinodanParamanathan has completed his Bachelor of Medicine and Bachelor of Surgery at the age of 25 years from the Peninsula College of Medicine and Dentistry, England, UK. He is a junior level Orthopaedic Surgeon at the University of Leicester teaching hospitals, England. UK. He has successfully completed a diploma in Medical Education and is involved in undergraduate education.He has published numerous case reports and clinical reviews in the field of surgery and haematology.


Introduction Triceps avulsion fracture rupture is a rare tendon. Radiography remains the initial imaging modality of choice for evaluating a suspected triceps injury. However, in children the osseous insertion may not be visible on standard plain film imaging if it is partially ossified. Presentation of Case An 8-year-old child presented to accident and emergency complaining of localised pain over the right olecranon following a fall onto an outstretched hand. The X-rays did not reveal a visible fracture however with subtle radiological signs and objective clinical findings an ultrasound was sought demonstrating a visibly avulsed bony fragment. Discussion This report demonstrates the importance of a thorough clinical examination needed to acquire a high index of suspicion as a missed or delayed diagnosis can lead to failure of surgical fixation resulting in prolonged disability. Conclusion The child underwent exploration under anaesthesia with anatomical reduction and fixation of the bony fragment with k-wires and periosteal sutures. Thereafter, following immobilisation in a cast the child regained full movement and power of extension.