Pediatric Terrible Elbow Tetrad: A Case Report and Systematic Review

A 6-year-old girl presented with a complex elbow injury, involving a posterior transolecranon fracture-dislocation and a radial neck fracture. Surgical intervention, performed through a posterior elbow approach, revealed an additional fracture of the coronoid process. Stabilization included a retrograde crossed K-wire for the radial neck fracture and a tension band construct (comprising K-wires and suture wire) for the olecranon fracture extending into the coronoid process. This combination of olecranon, radial neck, and coronoid fractures, coupled with a posterior elbow dislocation, constitutes a rare and intricate entity that may be regarded as a “terrible elbow tetrad”.