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J Orthop Case Rep. 2018 Sep-Oct;8(5):19-21. doi: 10.13107/jocr.2250-0685.1190.

Type III Monteggia Equivalent Lesion with Ipsilateral Fracture Lateral Condyle of Humerus in a Four-year-old Child: A Case Report and Literature Review.

Journal of orthopaedic case reports

Mark Bugeja, Arsen Avakyan, Eliezer Zahra Bianco, Thomas Azzopardi

Affiliations

  1. Department of Trauma and Orthopaedics, Mater Dei Hospital, Triq Dun Karm, Msida MSD 2090, Malta.

PMID: 30740367 PMCID: PMC6367291 DOI: 10.13107/jocr.2250-0685.1190

Abstract

INTRODUCTION: Monteggia fracture-dislocations are uncommon injuries in children, rarely associated with other ipsilateral upper limb injuries. We present a case of type III Monteggia lesion associated with an ipsilateral fracture of the lateral condyle of the humerus in a child.

CASE REPORT: A 4-year-old girl presented with a left elbow swelling after falling from a height of 2 meters. X-rays showed a fracture of the proximal ulna with lateral dislocation of the radial head (type III Monteggia) associated with an ipsilateral fracture of the lateral condyle of the humerus. The fractures were treated by closed reduction of the radial head dislocation, percutaneous Kirschner wire fixation of the proximal ulna fracture, and open reduction and Kirschner wire fixation of the lateral condyle.

CONCLUSION: Monteggia fracture-dislocations are challenging both in terms of diagnosis and management and may lead to late disability of the elbow and forearm if not detected early and treated appropriately. Operative management, in this case, gave an excellent result. We recommend operative treatment in these complex elbow fractures.

Keywords: Kirschner wires; Monteggia fracture-dislocation; children; lateral condyle fracture

Conflict of interest statement

Conflict of Interest: Nil

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