Surgical treatment of chronic Monteggia type I equivalent lesion in 11 year old: a rare case report.

Haveri, Sameer; Jatti, Ravi; Putti, B B · Eur J Orthop Surg Traumatol · 2012

case_report · Level V

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Abstract

The treatment of an unrecognized Monteggia lesion continues to pose a therapeutic challenge, as evidenced by the variety of surgical techniques described. The purpose of this study is to report one such rare case and its surgical treatment. Eleven-year-old girl presented to us with left elbow injury 6 weeks after fall. On examination, she had deformity and total restriction of elbow movements. X-ray showed upper third ulnar fracture with separation of radial head epiphysis suggesting Monteggia fracture type 1 equivalent. Ulnar osteotomy with plating and reduction of radial head separation with transcapitellar wire fixation was done. Above elbow cast given for 6 weeks. At 1 year follow-up, patient had regained good range of motion of elbow and forearm with maintenance of radial head reduction. This study stresses on the need of surgical treatment in treating chronic Monteggia fractures. In best hands, it gives excellent results.