Alajmi Turki Abdullah S
Department of Orthopaedic, Prince Mohammed Bin Abdulaziz Hospital - Riyadh, Kingdom of Saudi Arabia.
J Orthop Case Rep. 2020 Oct;10(7):57-62. doi: 10.13107/jocr.2020.v10.i07.1918.
Monteggia fracture dislocations are a relatively rare entity and they represent less than 2% of forearm fractures, the diagnosis can be missed in up to 50% of the time. The gold standard of treatment in adults has been open reduction and internal fixation, and closed reduction and cast immobilization in pediatrics.
We present three cases series of neglected Monteggia fractures in a 5-, 4-, and 9-year-old patients. The patients presented 10, 20, and 25 days post-injury, respectively. Each case was treated differently with the last case requiring open reduction and annular ligament reconstruction. All the three cases showed excellent results on follow-up.
To avoid missing these injuries, each patient should undergo a comprehensive clinical approach and adequate radiological imaging. Various treatment methods exist for neglected Monteggia fracture and each option should be exhausted to salvage the radial head starting with the less invasive approaches.
孟氏骨折脱位是一种相对罕见的病症,占前臂骨折的比例不到2%,高达50%的病例可能会漏诊。成人治疗的金标准是切开复位内固定,小儿则是闭合复位及石膏固定。
我们报告三例分别为5岁、4岁和9岁患者的被漏诊孟氏骨折病例。患者分别在受伤后10天、20天和25天就诊。每个病例的治疗方法不同,最后一例需要切开复位及环状韧带重建。所有三例患者随访结果均良好。
为避免漏诊这些损伤,每位患者都应接受全面的临床检查及充分的影像学检查。对于被漏诊的孟氏骨折,存在多种治疗方法,应首先尝试创伤较小的方法,用尽各种选项以挽救桡骨头。