Neglected Monteggia fracture treated with acute ulnar correction in a 12-year-old girl 3 years after the first injury: a case report

Chun-Hung Lin ； Shang-Ming Lin ； Chih-Hung Chang ； Tsung-Yu Lan

《Formosan Journal of Musculoskeletal Disorders》 13卷1期 (2022/02) Pp. 38-42

https://doi.org/10.6492/FJMD.202202_13(1).0005

摘要

Monteggia fracture accounts for 1% of all pediatric forearm fractures. Neglected Monteggia fracture-dislocation in the pediatric age group causes significant issues such as pain, stiffness, deformity, neurological compromise, and restriction of the ability to perform activities of daily living. We report a case of Monteggia fracture-dislocation (Bado type I) in a 12-year-old girl. She was incorrectly diagnosed as having an isolated greenstick ulnar fracture at a local hospital and treated with cast immobilization. Almost 3 years after the Monteggia fracture-dislocation was missed, she presented to the clinic with 30° hyperextension, 100° flexion, and 40° cubitus valgus of her right elbow. We performed acute ulnar corrective osteotomy using locking plate with annular ligament reconstruction and radial head open reduction. Two years after surgery, the elbow joint was stable without dislocation or subluxation. The flexion and extension of the right elbow were 130° and 0°, respectively. The patient was satisfied with the treatment outcomes.

關鍵字

annular ligament reconstruction ； dislocation ； Monteggia fracture ； ulnar corrective osteotomy