# Epiphyseal separation of the trochlea due to stress-throwing injury in a pediatric baseball player: A case report and review of the literature

## TL;DR

A rare case of elbow injury in a child baseball player caused by stress-throwing is reported, with successful treatment through open surgery.

## Contribution

Presents a rare pediatric case of stress-throwing-induced epiphyseal separation and suggests open surgery as a treatment option.

## Key findings

- Epiphyseal separation of the trochlea and capitellum avulsion fracture were confirmed via imaging.
- Open surgery using K-wires led to successful bone union and return to pain-free baseball.
- Suggests open surgery is suitable for distal humeral epiphyseal separation in children.

## Abstract

Distal humeral epiphyseal separation (DHES) is rare and sometimes difficult to diagnose by radiography. This report presents a rare case of an 8-year-old male baseball player with epiphyseal separation of the trochlea caused by a stress-throwing injury. The patient sustained an elbow injury after throwing a ball. Ultrasound and magnetic resonance imaging confirmed epiphyseal separation of the trochlea and avulsion fracture of the capitellum. Open surgery was performed using 1.5 mm diameter K-wires. After 5 weeks of immobilization, an active range of motion was allowed. Bone union was achieved 4 months after surgery. The patient returned to baseball without pain. Open surgery may be a suitable treatment option for DHES as children grow.

•Distal humeral epiphyseal separation is rare and sometimes difficult to diagnose.•Rare case of epiphyseal separation due to stress-throwing injury in a child•Open surgery may be a suitable treatment option for DHES as children grow.

Distal humeral epiphyseal separation is rare and sometimes difficult to diagnose.

Rare case of epiphyseal separation due to stress-throwing injury in a child

Open surgery may be a suitable treatment option for DHES as children grow.