Irreducible Monteggia fracture: beware nerve entrapment

Watson, J.A.S.; Singer, Georg

doi:10.1016/0020-1383(94)90246-1

Cited by 25 publications

(8 citation statements)

References 2 publications

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“…In an isolated anteromedial radial head dislocation, closed reduction alone is often unsuccessful due to soft tissue interposition from the annular ligament [8], biceps tendon [5, 6], median nerve [9], radial nerve [10], or joint capsule [4, 11]. The direct posterior approach used in this case provided a safe operative window allowing full visualisation and subsequent reduction of the dislocated radial head and anatomical fixation of the associated olecranon fracture.…”

Section: Discussionmentioning

confidence: 99%

Medial Radial Head Dislocation Associated with a Proximal Olecranon Fracture: A Bado Type V?

Segaren

Abdul-Jabar

Segaren

et al. 2014

Case Reports in Surgery

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The Monteggia fracture is relatively rare. We present an unreported configuration of a traumatic olecranon fracture with a concomitant medial radial head dislocation in a 3-year-old male. This injury was initially missed and required a subsequent operative intervention. Following surgery, there was evident fracture union, articular congruency, and a full functional recovery. Medial radial head dislocation is not accounted for in the Bado (1967) classification of the Monteggia lesion and hence we propose the addition of a Bado V category.

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Section: Discussionmentioning

confidence: 99%

Medial Radial Head Dislocation Associated with a Proximal Olecranon Fracture: A Bado Type V?

Segaren

Abdul-Jabar

Segaren

et al. 2014

Case Reports in Surgery

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“…Neviaser and LeFevre 22 reported the case of a 7-year-old boy with a dislocated radial head, protruded through a transverse tear capsule, with no damage to the annular ligament. Other reported factors causing irreducible dislocations include the biceps tendon, the median nerve radial nerve, osteochondral bone fragments, etc., interposed in the joint space 15,[23][24][25] . Some authors reported finding the factors with MRI scans.…”

Section: Discussionmentioning

confidence: 99%

“…The most commonly reported factors are annular ligament and anterior capsules; however, others include the biceps tendon, the median nerve radial nerve, osteochondral bone fragments, etc. [19][20][21][22][23][24][25] . We herein introduce a case of radial head dislocation, which was detected 5 days after the initial trauma and treated by open reduction, repair of the annular ligament, with no need for osteotomy or joint fixation, and resulted in an excellent outcome.…”

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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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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“…We believe that this could be easily missed on plain films, and that CT would be a reasonable imaging modality in elbow injuries locked in supination or pronation. A variety of blocks to reduction have been described in patients, including the biceps tendon, 1,2 joint capsule, 4 and even the radial nerve, 5 but never the bony block of the coronoid. This case is interesting and unusual due to the delayed complication of a posttraumatic synostosis.…”

Section: Discussionmentioning

confidence: 99%