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Beutel BG, Klifto CS, Chu A. Percutaneous reduction and flexible intramedullary nailing for monteggia fracture in a skeletally mature patient. Int J Surg Case Rep. 2014;5(12):1261-4doi: 10.1016/j.ijscr.2014.11.057.
Beutel, B. G., Klifto, C. S., & Chu, A. (2014). Percutaneous reduction and flexible intramedullary nailing for monteggia fracture in a skeletally mature patient. International journal of surgery case reports, 5(12), 1261-4. https://doi.org/10.1016/j.ijscr.2014.11.057
Beutel, Bryan G, et al. "Percutaneous reduction and flexible intramedullary nailing for monteggia fracture in a skeletally mature patient." International journal of surgery case reports vol. 5,12 (2014): 1261-4. doi: https://doi.org/10.1016/j.ijscr.2014.11.057
Beutel BG, Klifto CS, Chu A. Percutaneous reduction and flexible intramedullary nailing for monteggia fracture in a skeletally mature patient. Int J Surg Case Rep. 2014;5(12):1261-4. doi: 10.1016/j.ijscr.2014.11.057. Epub 2014 Nov 21. PMID: 25460489; PMCID: PMC4275958.
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Int J Surg Case Rep. 2014;5(12):1261-4. doi: 10.1016/j.ijscr.2014.11.057. Epub 2014 Nov 21.

Percutaneous reduction and flexible intramedullary nailing for monteggia fracture in a skeletally mature patient.

International journal of surgery case reports

Bryan G Beutel, Christopher S Klifto, Alice Chu

Affiliations

  1. NYU Hospital for Joint Diseases, Department of Orthopaedic Surgery, 301 East 17th Street, New York, NY 10003, USA. Electronic address: [email protected].
  2. NYU Hospital for Joint Diseases, Department of Orthopaedic Surgery, 301 East 17th Street, New York, NY 10003, USA.

PMID: 25460489 PMCID: PMC4275958 DOI: 10.1016/j.ijscr.2014.11.057

Abstract

INTRODUCTION: Monteggia lesions are defined as a fracture of the proximal ulna with an associated radial head dislocation. Management of these injuries varies depending upon the patient population, ranging from non-operative treatment with closed reduction and immobilization to surgical fixation. Percutaneous techniques of radial head reduction are often reserved for skeletally immature patients.

PRESENTATION OF CASE: In this case report, a 14-year-old female presented with left elbow pain three days after a fall. Radiographs and CT images from an outside hospital revealed a displaced left radial head fracture and a non-displaced proximal olecranon fracture, consistent with a Monteggia equivalent fracture. The patient underwent percutaneous reduction and internal fixation of the radial head with a flexible intramedullary nail (Metaizeau technique), and open reduction and internal fixation of the olecranon. She developed a 25 degree left elbow flexion contracture and, five months after her index procedure, underwent arthroscopic release and removal of hardware. The radial head reduction was near anatomic and she regained full extension.

DISCUSSION: This report demonstrates that percutaneous reduction with intramedullary nailing and fixation techniques can be performed successfully in skeletally mature patients.

CONCLUSION: Given their less invasive nature, we recommend attempting percutaneous interventions in some skeletally mature individuals for fracture reduction and fixation.

Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Keywords: Metaizeau; Monteggia; Percutaneous; Skeletally mature

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