Tags

Type your tag names separated by a space and hit enter

A Long-standing Monteggia Fracture in a Child who underwent Bone Lengthening and Annular Ligament Reconstruction: A Case Report.
J Orthop Case Rep 2019; 9(3):30-33JO

Abstract

Introduction

Monteggia fractures are rare and account for 1% of all pediatric forearm fractures. Dislocation of the radial head with plastic deformation of the ulna is particularly rare and can be overlooked, thereby resulting in long effects. Here, we report the treatment of a case of a long-standing Monteggia fracture in a child.

Case Report

A 6-year-old girl who was injured by a fall was examined by a local physician. 4 weeks later, she was referred to our hospital. Plain X-ray and computed tomography revealed a long-standing Monteggia fracture. Ulnar osteotomy was performed; however, complete realignment was not achieved. Scar tissue and the annular ligament remained intact, thereby hindering complete reduction. The scar tissue surrounding the radial head was surgically removed, and subluxation was reduced. The annular ligament was reconstructed, and the ulna was lengthened by external fixation. 1 year postoperatively, the patient's elbow range of motion is good, and there has been no recurrence of radial head dislocation.

Conclusions

The patient achieved good progress through the use of annular ligament reconstruction and ulnar osteotomy to straighten and anatomically realign the ulna. Post-operative repeat dislocation was avoided by reducing radial head dislocation, removing the scar tissue, and reconstructing the annular ligament.

Authors+Show Affiliations

DepartmentofOrthopaedics, Fujigaoka Hospital, Showa University School of Medicine, Yokohama, Japan.DepartmentofOrthopaedics, Fujigaoka Hospital, Showa University School of Medicine, Yokohama, Japan.DepartmentofOrthopaedics, Fujigaoka Hospital, Showa University School of Medicine, Yokohama, Japan.DepartmentofOrthopaedics, Fujigaoka Hospital, Showa University School of Medicine, Yokohama, Japan.DepartmentofOrthopaedics, Fujigaoka Hospital, Showa University School of Medicine, Yokohama, Japan.DepartmentofOrthopaedics, Fujigaoka Hospital, Showa University School of Medicine, Yokohama, Japan.

Pub Type(s)

Case Reports

Language

eng

PubMed ID

31559222

Citation

Shinohara, Daichi, et al. "A Long-standing Monteggia Fracture in a Child Who Underwent Bone Lengthening and Annular Ligament Reconstruction: a Case Report." Journal of Orthopaedic Case Reports, vol. 9, no. 3, 2019, pp. 30-33.
Shinohara D, Yasuda T, Arai M, et al. A Long-standing Monteggia Fracture in a Child who underwent Bone Lengthening and Annular Ligament Reconstruction: A Case Report. J Orthop Case Rep. 2019;9(3):30-33.
Shinohara, D., Yasuda, T., Arai, M., Sato, K., Arima, T., & Kanzaki, K. (2019). A Long-standing Monteggia Fracture in a Child who underwent Bone Lengthening and Annular Ligament Reconstruction: A Case Report. Journal of Orthopaedic Case Reports, 9(3), pp. 30-33. doi:10.13107/jocr.2250-0685.1406.
Shinohara D, et al. A Long-standing Monteggia Fracture in a Child Who Underwent Bone Lengthening and Annular Ligament Reconstruction: a Case Report. J Orthop Case Rep. 2019;9(3):30-33. PubMed PMID: 31559222.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A Long-standing Monteggia Fracture in a Child who underwent Bone Lengthening and Annular Ligament Reconstruction: A Case Report. AU - Shinohara,Daichi, AU - Yasuda,Tomohiro, AU - Arai,Masayuki, AU - Sato,Kaoru, AU - Arima,Toshihiko, AU - Kanzaki,Koji, PY - 2019/9/28/entrez PY - 2019/9/29/pubmed PY - 2019/9/29/medline KW - Annular ligament reconstruction KW - External fixator KW - Monteggia fracture KW - Pediatric KW - Radial head dislocation SP - 30 EP - 33 JF - Journal of orthopaedic case reports JO - J Orthop Case Rep VL - 9 IS - 3 N2 - Introduction: Monteggia fractures are rare and account for 1% of all pediatric forearm fractures. Dislocation of the radial head with plastic deformation of the ulna is particularly rare and can be overlooked, thereby resulting in long effects. Here, we report the treatment of a case of a long-standing Monteggia fracture in a child. Case Report: A 6-year-old girl who was injured by a fall was examined by a local physician. 4 weeks later, she was referred to our hospital. Plain X-ray and computed tomography revealed a long-standing Monteggia fracture. Ulnar osteotomy was performed; however, complete realignment was not achieved. Scar tissue and the annular ligament remained intact, thereby hindering complete reduction. The scar tissue surrounding the radial head was surgically removed, and subluxation was reduced. The annular ligament was reconstructed, and the ulna was lengthened by external fixation. 1 year postoperatively, the patient's elbow range of motion is good, and there has been no recurrence of radial head dislocation. Conclusions: The patient achieved good progress through the use of annular ligament reconstruction and ulnar osteotomy to straighten and anatomically realign the ulna. Post-operative repeat dislocation was avoided by reducing radial head dislocation, removing the scar tissue, and reconstructing the annular ligament. SN - 2250-0685 UR - https://www.unboundmedicine.com/medline/citation/31559222/A_Long-standing_Monteggia_Fracture_in_a_Child_who_underwent_Bone_Lengthening_and_Annular_Ligament_Reconstruction:_A_Case_Report L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/31559222/ DB - PRIME DP - Unbound Medicine ER -