Missed chronic anterior Monteggia lesion. Closed reduction by gradual lengthening and angulation of the ulna.
Two consecutive cases of chronic dislocation of the head of the radius after missed Bado type-I Monteggia lesions are presented. Reduction was successfully achieved in both patients after ulnar corticotomy, gradual lengthening and angulation of the ulna using an external fixator. Open reduction or reconstruction of the radio-ulnar capitellar joint was not undertaken. The age at injury was seven years in the older and two years in the younger patient. The time from injury to treatment was five years in the older and three months in the younger child. At follow-up, nine years after completion of treatment in the older and eight months in the younger patient, both show satisfactory movement, function of the forearm and reduction of the head of the radius. This technique may be considered in missed Monteggia lesions before open procedures on the radio-ulnar capitellar joint are undertaken.
Exner
G U
GU
Section of Paediatric and Tumour Orthopaedics, Orthopädische Universitätsklinik, Zürich, Switzerland.
D001852:Bone Lengthening / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D009011:Monteggia's Fracture / Q000175:diagnosis / Q000628:therapy*; D013997:Time Factors; D014458:Ulna Fractures / Q000601:surgery