Type II Monteggia Lesion with Complete Elbow Dislocation in a Cat

Abstract

A 2-year-old neutered male cat was presented for right forelimb non-weight-bearing lameness. A fracture of the proximal third of the ulna (associated with a caudal radio-humeral and humero-ulnar dislocations and a radio-ulnar dislocation) was radiographically identified, leading to a diagnosis of type II Monteggia lesion with complete elbow joint dislocation. The ulnar fracture was reduced and stabilized using an intramedullary pin. During surgery, the lateral collateral ligament and the annular ligament appeared disrupted. The radio-ulnar dislocation was reduced and stabilized, using a double-loop suture prosthesis passing through the metaphysis of the ulna and around the radial head. The radio-humeral dislocation was reduced and stabilized using a lateral collateral suture prosthesis. No postoperative complications were observed and the patient regained good elbow joint range of motion, with no significant lameness at 8 postoperative months.

Effects of simulated radioulnar synostosis on supination and pronation in cats. A cadaveric study

“…[16][17][18][19][20] Alternatives, with a reconstruction of the annular ligament with bone tunnels and Tight Rope (Arthrex Vet Systems, Naples, Florida) or double loop suture prosthesis around the radial head for Monteggia fractures or radial head luxations are described and successfully carried out in clinical cases. [30][31][32] In proximal nonreducible radial fractures, external skeletal fixator configurations engaging the olecranon proximally and the radius distally are described. 20 This configuration should be avoided if ever possible.…”

“…Reasons for impaired radioulnar rotation can be synostosis formations after mid‐diaphyseal antebrachial fractures or surgical procedures with disruption of the annular ligament recommending temporary iatrogenic synostosis formations 16–20 . Alternatives, with a reconstruction of the annular ligament with bone tunnels and Tight Rope (Arthrex Vet Systems, Naples, Florida) or double loop suture prosthesis around the radial head for Monteggia fractures or radial head luxations are described and successfully carried out in clinical cases 30–32 . In proximal nonreducible radial fractures, external skeletal fixator configurations engaging the olecranon proximally and the radius distally are described 20 .…”