Paediatric triceps avulsion fracture identified with ultrasound

INTRODUCTIONTriceps 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 CASEAn 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.DISCUSSIONThis 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.CONCLUSIONThe 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.