Arthroscopic Management of a Bucket-Handle Acetabular Labral Tear in a Pediatric Patient: A Rare Case Report with Associated Fleck Sign

儿童桶柄状髋臼盂唇撕裂的关节镜治疗:一例罕见病例报告及伴随的斑点征

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Abstract

INTRODUCTION: Bucket-handle tears of the acetabular labrum are rare injuries, especially in pediatric patients. Typically resulting from high-energy trauma, they are often challenging to diagnose due to subtle clinical signs and non-specific imaging findings. CASE REPORT: We report the case of a pediatric patient presenting with progressive hip pain and functional limitation after trauma. Advanced imaging revealed a displaced labral fragment consistent with a bucket-handle tear and a Fleck sign on computed tomography, indicating a posterior osteochondral avulsion. Arthroscopic exploration confirmed that the labral tissue was fibrotic and calcified, rendering it irreparable. Resection of the lesion and removal of the osteochondral fragment were performed, resulting in significant pain relief and functional recovery. CONCLUSION: This case underscores the importance of early clinical suspicion and prompt advanced imaging in pediatric hip trauma. Delayed diagnosis may lead to chronic changes that compromise the feasibility of labral repair.

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