Bugeja Mark, Avakyan Arsen, Bianco Eliezer Zahra, Azzopardi Thomas
Department of Trauma and Orthopaedics, Mater Dei Hospital, Triq Dun Karm, Msida MSD 2090, Malta.
J Orthop Case Rep. 2018 Sep-Oct;8(5):19-21. doi: 10.13107/jocr.2250-0685.1190.
Monteggia fracture-dislocations are uncommon injuries in children, rarely associated with other ipsilateral upper limb injuries. We present a case of type III Monteggia lesion associated with an ipsilateral fracture of the lateral condyle of the humerus in a child.
A 4-year-old girl presented with a left elbow swelling after falling from a height of 2 meters. X-rays showed a fracture of the proximal ulna with lateral dislocation of the radial head (type III Monteggia) associated with an ipsilateral fracture of the lateral condyle of the humerus. The fractures were treated by closed reduction of the radial head dislocation, percutaneous Kirschner wire fixation of the proximal ulna fracture, and open reduction and Kirschner wire fixation of the lateral condyle.
Monteggia fracture-dislocations are challenging both in terms of diagnosis and management and may lead to late disability of the elbow and forearm if not detected early and treated appropriately. Operative management, in this case, gave an excellent result. We recommend operative treatment in these complex elbow fractures.
孟氏骨折脱位在儿童中并不常见,很少与同侧上肢其他损伤相关。我们报告一例儿童III型孟氏损伤合并同侧肱骨外侧髁骨折的病例。
一名4岁女孩从2米高处跌落,出现左肘部肿胀。X线显示尺骨近端骨折伴桡骨头外侧脱位(III型孟氏骨折),合并同侧肱骨外侧髁骨折。通过闭合复位桡骨头脱位、经皮克氏针固定尺骨近端骨折以及切开复位和克氏针固定外侧髁来治疗骨折。
孟氏骨折脱位在诊断和治疗方面都具有挑战性,如果不及早发现并进行适当治疗,可能会导致肘部和前臂的晚期残疾。在本病例中,手术治疗取得了极佳的效果。我们建议对这些复杂的肘部骨折进行手术治疗。