Management of Neglected Pediatric Monteggia Fracture-Dislocation: A Case Report with Literature Review

Abstract

Background: Missed or neglected Monteggia lesions are defined as the classical fracture-dislocation presenting at least four weeks after injury. This injury in children is often challenging to treat and requires complex methods to achieve optimal results. Case Report: We present the case of a 6-year-old girl with a 2-month-old neglected Bado Type-I Monteggia fracture-dislocation. After mismanagement by a traditional bone setter, our patient underwent ulnar osteotomy, bone graft, and fixation with a semi-tubular plate along with open radial head reduction. Although the patient experienced wound complications at the bone graft site, she achieved an excellent outcome with restored functionality and range of motion. Conclusion: Neglected Monteggia injuries in pediatric patients demand multifaceted treatment approaches due to their complexity and potential for long-term functional impairment. The absence of a consensus on definitive treatment underscores the importance of early diagnosis and open reduction to enhance long-term outcomes. This case report highlights the effectiveness of ulnar osteotomy, plate fixation, and open radial head reduction in achieving favorable results.

Keywords

• Monteggia fracture dislocations
• Neglected Monteggia’s fracture
• Forearm Injuries
• Ulna Osteotomy