Neglected Monteggia fracture dislocation in children: The impact of step cut osteotomy on ulna consolidation and radial head reduction. A case report
Background: Monteggia fracture is identified as ulna fracture combined with radial head dislocation. If not diagnosed at an early stage, it leads to elbow impairment including: cubitus valgus, elbow instability and deformity, decreased supination-pronation arc and late neuropathy resulting in signif...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-09-01
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| Series: | Journal of Orthopaedic Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2773157X23000589 |
| _version_ | 1797669711644721152 |
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| author | Aymen Ben Fredj Hedi Rbai Farouk Chatbouri Abderrahmen Daadoucha |
| author_facet | Aymen Ben Fredj Hedi Rbai Farouk Chatbouri Abderrahmen Daadoucha |
| author_sort | Aymen Ben Fredj |
| collection | DOAJ |
| description | Background: Monteggia fracture is identified as ulna fracture combined with radial head dislocation. If not diagnosed at an early stage, it leads to elbow impairment including: cubitus valgus, elbow instability and deformity, decreased supination-pronation arc and late neuropathy resulting in significant restriction of daily activities. Case report: A 10-year-old boy with a two months old Monteggia fracture dislocation labelled Bado Type 1 was evaluated. Open reduction of radial head, annular ligament repair and step cut osteotomy of the ulna were performed. Eight months after operation, the osteotomy site was fully and uneventfully consolidated and the radial head kept its stable reduction. The elbow has regained normal mobility. Conclusion: Neglected Monteggia fracture dislocation requires specific surgical management to avoid further complications. Step cut osteotomy in neglected Monteggia fracture has several advantages over other techniques. It allows the osteotomy site to be lengthened and angled forward while maintaining a large bone-to-bone contact surface which avoids the use of bone grafting. Maximizing the contact surface at the osteotomy leads to a good consolidation rate and also results in increased stability. |
| first_indexed | 2024-03-11T20:48:28Z |
| format | Article |
| id | doaj.art-7887034f92824443a7a7013eed43c003 |
| institution | Directory Open Access Journal |
| issn | 2773-157X |
| language | English |
| last_indexed | 2024-03-11T20:48:28Z |
| publishDate | 2023-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Orthopaedic Reports |
| spelling | doaj.art-7887034f92824443a7a7013eed43c0032023-10-01T06:03:51ZengElsevierJournal of Orthopaedic Reports2773-157X2023-09-0123100186Neglected Monteggia fracture dislocation in children: The impact of step cut osteotomy on ulna consolidation and radial head reduction. A case reportAymen Ben Fredj0Hedi Rbai1Farouk Chatbouri2Abderrahmen Daadoucha3Orthopaedics Department, Ibn El Jazzar Hospital, Université de Sousse Faculté de Médecine de Sousse, Sousse, Tunisia; Corresponding author.Orthopaedics Department, Ibn El Jazzar Hospital, Université de Sousse Faculté de Médecine de Sousse, Sousse, TunisiaOrthopaedics Department, Ibn El Jazzar Hospital, Université de Sousse Faculté de Médecine de Sousse, Sousse, TunisiaRadiology Department, Ibn El Jazzar Hospital, Université de Sousse Faculté de Médecine de Sousse, Sousse, TunisiaBackground: Monteggia fracture is identified as ulna fracture combined with radial head dislocation. If not diagnosed at an early stage, it leads to elbow impairment including: cubitus valgus, elbow instability and deformity, decreased supination-pronation arc and late neuropathy resulting in significant restriction of daily activities. Case report: A 10-year-old boy with a two months old Monteggia fracture dislocation labelled Bado Type 1 was evaluated. Open reduction of radial head, annular ligament repair and step cut osteotomy of the ulna were performed. Eight months after operation, the osteotomy site was fully and uneventfully consolidated and the radial head kept its stable reduction. The elbow has regained normal mobility. Conclusion: Neglected Monteggia fracture dislocation requires specific surgical management to avoid further complications. Step cut osteotomy in neglected Monteggia fracture has several advantages over other techniques. It allows the osteotomy site to be lengthened and angled forward while maintaining a large bone-to-bone contact surface which avoids the use of bone grafting. Maximizing the contact surface at the osteotomy leads to a good consolidation rate and also results in increased stability.http://www.sciencedirect.com/science/article/pii/S2773157X23000589Missed Monteggia fractureChildrenUlna osteotomyOpen reduction |
| spellingShingle | Aymen Ben Fredj Hedi Rbai Farouk Chatbouri Abderrahmen Daadoucha Neglected Monteggia fracture dislocation in children: The impact of step cut osteotomy on ulna consolidation and radial head reduction. A case report Journal of Orthopaedic Reports Missed Monteggia fracture Children Ulna osteotomy Open reduction |
| title | Neglected Monteggia fracture dislocation in children: The impact of step cut osteotomy on ulna consolidation and radial head reduction. A case report |
| title_full | Neglected Monteggia fracture dislocation in children: The impact of step cut osteotomy on ulna consolidation and radial head reduction. A case report |
| title_fullStr | Neglected Monteggia fracture dislocation in children: The impact of step cut osteotomy on ulna consolidation and radial head reduction. A case report |
| title_full_unstemmed | Neglected Monteggia fracture dislocation in children: The impact of step cut osteotomy on ulna consolidation and radial head reduction. A case report |
| title_short | Neglected Monteggia fracture dislocation in children: The impact of step cut osteotomy on ulna consolidation and radial head reduction. A case report |
| title_sort | neglected monteggia fracture dislocation in children the impact of step cut osteotomy on ulna consolidation and radial head reduction a case report |
| topic | Missed Monteggia fracture Children Ulna osteotomy Open reduction |
| url | http://www.sciencedirect.com/science/article/pii/S2773157X23000589 |
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