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Case Reports
. 2023 Nov;13(11):24-27.
doi: 10.13107/jocr.2023.v13.i11.3992.

Atypical Monteggia Fracture Dislocation Type 3 Equivalent Lesion in a 4- Year- Old Boy

Alparslan Uzun  1 , Joud Abou Rdan  2 , Elif Betül Balcı  2 , Eyüp Deniz  2 , Maral Mahoutforoush  1 , Adnan Kara  1
Affiliations
Case Reports

Atypical Monteggia Fracture Dislocation Type 3 Equivalent Lesion in a 4- Year- Old Boy

Alparslan Uzun et al. J Orthop Case Rep. 2023 Nov.

Abstract

Introduction: Monteggia fracture dislocations are relatively common and debilitating traumas in <10 years of age. This is the second case reporting Monteggia type 3 equivalent injury treated by the same way while the first being reported also by our team in 2016.

Case report: A 4-year-old Caucasian male patient was admitted to our clinic by his parents at the day after his fall. A long arm splint was applied with the diagnosis of Monteggia fracture dislocation in another hospital.

Conclusion: Bado introduced his classification system for Monteggia fracture dislocations in 1967. This classification system is mainly based on the direction of dislocation of the radial head. If radial head dislocated laterally with an accompanying ulnar fracture it is classified as Bado type 3 while type 4 is the anterior dislocation of the radial head accompanied with both bone forearm fracture. The unusual fracture dislocation pattern in our case is that lateral dislocation of the radial head is accompanied with both bone forearm fracture, which is an example to be named as Monteggia type 3 equivalent lesion. Closed reduction was not successful to reduce radial head. To reduce the radial head, we used an intramedullary Kirschner and a long arm splint was applied to ensure the safety of the reduction. There was no restriction in elbow movements and the result of the operation was successful.

Keywords: Monteggia fracture; bado classification; radius dislocation; ulna fracture.

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Conflict of interest statement

Conflict of Interest: Nil

Figures

Figure 1
Figure 1
AP (a) and lateral (b) views of the healthy side with radiocapitellar lines. AP (c) and lateral (d) views of the injured side with radiocapitellar lines after closed reduction. Note the lateral radial head dislocation in AP view.
Figure 2
Figure 2
Successful reduction of radial head and both bone fracture in AP and lateral views.
Figure 3
Figure 3
Radiographs after K-wire removal at 8th week. There is no obvious pathology involving elbow joint.
Figure 4
Figure 4
Clinical photos show no restriction in elbow movements at 12th week after surgery.
See this image and copyright information in PMC

References

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