Bowing Fracture With Literature Review

Malik, Mariam; Demos, Terrence C; Lomasney, Laurie M; Stirling, Jerold M.

doi:10.3928/01477447-20151222-01

Cited by 7 publications

(3 citation statements)

References 15 publications

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“…However, there are a few cases in which reduction of the dislocation cannot be accomplished by a closed procedure because the interposition of soft tissues in the radiohumeral joint obstructed the reduction. Other authors reported the most common interposed factors were annular ligament and anterior capsules [13][14][15] . In our case, it was an annular ligament, which was confirmed on both MRI films and intra-operative expose.…”

Section: Discussionmentioning

confidence: 93%

“…It can be detected if one carefully evaluates the radiographs of an injured elbow, taking into account the radiocapitellar line and the ulnar bow 12 . Such an irreducible traumatic dislocation can be easily missed and whose later detections are often diagnosed as a neglected Monteggia fracture [13][14][15] . The rate of missed injuries has been as high as 50% 16 .…”

Section: Introductionmentioning

confidence: 99%

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Irreducible Traumatic Radial Head Dislocation Due to Annular Ligament Interposition in a Child with Ulnar Plastic Deformation: A Case Report

Tran

Nguyen

et al. 2021

Orthopaedic Surgery

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Background:The traumatic dislocation of the radial head in children is commonly treated by closed reduction. Sometimes, however, this strategy of treatment may not be effective due to the location of soft tissues in the radio-shoulder joint. The literature presents a few cases of the irreducible radial head dislocation with ulnar plastic deformation. Because it is a relatively rare condition, such a traumatic dislocation can be easily missed. Neglected injuries can lead to unwanted complications and unpredictable surgical outcomes.Case presentation: This study presents a relatively rare case of traumatic radial head dislocation with ulnar plastic deformation in a 3-year-old child, which was successfully treated by open reduction. The examined case did not require osteotomy and ligamentous reconstruction. The initial attempt of closed reduction failed due to annular ligament interposition, which has been detected on MRI. After 3 months of treatment, the range of motion of the operated arm gradually improved. At the 6-month follow-up, the Mayo elbow-performance score indicated an excellent treatment outcome. Conclusions:The delayed treatment of radial head dislocation with ulnar plastic deformation can hinder the supination and pronation of the forearm, resulting in elbow/forearm deformity. The earlier this condition is detected, the easier it will be to treat it and the better the treatment outcome will be. The examined case of irreversible traumatic dislocation, successfully treated by open reduction, may help to treat radial head dislocation better.

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Section: Discussionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Irreducible Traumatic Radial Head Dislocation Due to Annular Ligament Interposition in a Child with Ulnar Plastic Deformation: A Case Report

Tran

Nguyen

et al. 2021

Orthopaedic Surgery

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“…They predominantly take place in the pediatric population where the radius and ulna are the most frequently described injury sites and often originate from a fall on the outstretched hand. Furthermore, bowing fractures of the forearm can occur either isolated or in conjunction with joint dislocation or a fracture of the accompanying bone [2] . Correct diagnosis has proven to be challenging due to the absence of a clear cortical defect on radiographic images, the possibility of the plastic deformity only being visible on a strict anteroposterior (AP) or lateral view and the lack of or late formation of periosteal callus formation [3] .…”

Section: Introductionmentioning

confidence: 99%

The importance of adequate diagnosis of pediatric forearm bowing fractures: A case report

Vervaecke

Nuyts

Sys

2021

Trauma Case Reports

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Introduction Correct diagnosis of pediatric bowing fractures has proven to be challenging. Consequently, these entities are often underdiagnosed both at the initial presentation and at further follow-up. We present a case of an ulnar fracture with subsequent non-union and initially missed associated plastic deformity of the radius to highlight the importance of adequate diagnosis of bowing fractures and obtaining appropriate imaging in pediatric forearm trauma to prevent sequelae. Case presentation A 13-year old male sustained a diaphyseal fracture of the left ulna after a fall on the outstretched hand which was treated conservatively. A non-impact incident (push up on outstretched arm) 4.5 months after the initial trauma caused an ulnar fracture at the same location and was initially considered a simple refracture. Operative treatment was decided on due to significant clinical forearm valgus alignment. Intraoperatively however, a mobile non-union of the ulna was found and anatomic reduction was not possible due to radial bowing. Exploration of the radius showed a clear malalignment with periosteal callus reaction, indicative of a mal-union of the radial bone as a result of the initial injury. To correctly restore alignment, a closing wedge osteotomy of the radius was necessitated followed by plate and screw fixation of both the radius and the ulna. Conclusion In this patient, failure of recognizing the associated plastic deformity of the radius during the initial presentation led to radial malunion and non-union of the ulna. As a result of this complication, an osteotomy was necessary which probably could have been prevented if an adequate initial diagnosis had been made.

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Long-term follow-up of corrective ulnar osteotomy for missed Monteggia fractures in children

Stragier

Smet

Degreef

2018

Journal of Shoulder and Elbow Surgery

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Bowing Fracture With Literature Review

Abstract: A 5-year-old boy was brought to the emergency department after a fall from a jungle gym. He had persistent pain and swelling of his left forearm.

Cited by 7 publications

References 15 publications

Irreducible Traumatic Radial Head Dislocation Due to Annular Ligament Interposition in a Child with Ulnar Plastic Deformation: A Case Report

Irreducible Traumatic Radial Head Dislocation Due to Annular Ligament Interposition in a Child with Ulnar Plastic Deformation: A Case Report

The importance of adequate diagnosis of pediatric forearm bowing fractures: A case report

Long-term follow-up of corrective ulnar osteotomy for missed Monteggia fractures in children

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