[Homolateral Monteggia and Galeazzi fractures: a case report and review of the literature].
We report a very rare case of Monteggia and Galeazzi fractures of the same forearm in a 23-year-old female traffic accident victim. Fractures of the two forearm bones were reduced and fixed with a solid assembly. Dislocation of the radial head reduced spontaneously. Inferior radioulnar instability was treated by blocking the joint with a K wire for one month. At 24 months, outcome was satisfactory with 40 degrees pronation and 70 degrees supination. Elbow and wrist flexion-extension and muscle force were the same as on the healthy side. Surgery is indicated in this rare association in adults. As it is very important to restore exactly the anatomy with solid fixation of the ulna to achieve and maintain reduction of the radial head. Surgical exploration of the humeroradial joint is not required unless reduction cannot be achieved. The same is true for fixation of the radius after Galeazzi fracture. If an inferior radioulnar instability persists, we propose temporary stabilization with a K wire. Our experience with this case would argue against first intention resection of the distal portion of the ulna as proposed by Hughston. We prefer to postpone resection which would be performed only in case of bothersome instability. A Sauvé-Kapandji procedure would then be a possible solution.
Kanso
I
I
Service de Chirurgie Orthopédique et Traumatologique, Centre Hospitalier de Juvisy-sur-Orge, 9, rue Camille-Flammarion, 91260 Juvisy-sur-Orge.
Tawil
H J
HJ
Lignac
F
F
D000328:Adult; D005260:Female; D006801:Humans; D004204:Joint Dislocations / Q000150:complications* / Q000601:surgery; D011885:Radius Fractures / Q000150:complications* / Q000601:surgery; D014458:Ulna Fractures / Q000150:complications* / Q000601:surgery; D014955:Wrist Joint