A rare type III Monteggia equivalent lesion in an eight-year-old girl: A case report and literature review

Abstract

Introduction: Monteggia fracture-dislocations are infrequent in children accounting for approximately 2% of childhood elbow fractures, and diagnosis, mechanism of injury, treatment, and outcome are still challenging. We present a type III Monteggia equivalent lesion with fracture of the ulna, lateral condylar fracture, and lateral dislocation of radius in an 8-year-old girl. Case report: The patient presented with pain, swelling, and inability to move her right arm. No neurovascular injuries were detected. The patient was given analgesics, and the radial head was fixed with closed reduction in the emergency department. Her elbow was immobilized with a long arm splint, and she underwent surgery the day after. The lateral condylar fracture was fixed by using three 1.5 mm Kirchner wires (K-wires) to treat the humeral fracture. One 3.5 mm reconstruction plate was used to fix the ulnar fracture; however, it was not reduced properly, and the patient was referred to our hospital. She underwent surgery two days after the first surgery, the reconstruction plate was removed, and the ulnar fracture was fixed with a 3.5 mm 4-hole dynamic compression plate with cortical screws and three K-wires, and a long arm cast was applied. The patient was visited every two weeks with no complaints or complications. Six weeks after the surgery, the cast was split, and the three humeral and two ulnar K-wires were removed. Two weeks later, the other K-wire, which managed the medial facet involvement, was removed too. She had no complaints, and no complication was noted in the physical examination or radiographs.Her range of motion and rotation had returned completely two weeks later, and radiographs showed no complications.

Keywords

• Monteggia fracture-dislocation
• Lateral condyle fracture
• Pediatrics
• Internal fracture fixation
• Case report