Trash Lesions Around the Elbow: A Review of Approach to Diagnosis and Management

TRASH lesions are a group of special injuries around the elbow resulting from high energy trauma that are routinely missed at initial presentation because of seemingly normal X-rays. These are a group of osteochondral injuries having a high propensity for surgical intervention and usually have poor outcomes if not treated adequately. Prompt diagnosis warrants a high index of suspicion even when a radiograph appears to be normal with a disproportionately swollen elbow in a child. TRASH lesions include radial head osteochondral fractures, medial condylar fractures in unossified elbow, transphyseal separations of the distal humerus, monteggia lesions, entrapped incarcerated medial epicondylar fractures, capitellar shear fractures, lateral condylar fractures extending to the cartilage. This article attempts to review in brief, the approach to early diagnosis and management with literature review and case examples.