Delayed treatment of a neonatal type-I Monteggia fracture-dislocation: a case report. Issue 2 (March 2018)

• Record Type: Journal Article
• Authors: Smith, William R.; Kozin, Scott H.; Zlotolow, Dan A.
• Is Part Of: Journal of pediatric orthopedics. Volume 27:Issue 2(2018)
• Publication Date: 2018-03
• Subjects: case report -- delayed diagnosis -- fracture dislocation -- Monteggia -- neonatal; Pediatric orthopedics -- Periodicals; 618.927005
• DOI: 10.1097/BPB.0000000000000439
• Languages: English
• ISSNs: 1060-152X

Abstract

Abstract : Delayed diagnosis of a Monteggia fracture-dislocation changes a straightforward, treatable injury into a complex problem. Acute neonatal injuries may be missed because of the inability to visualize the unossified skeleton on radiography, interpreted later as 'congenital' dislocations. We report the case of a 14-month-old with a neonatal Monteggia type-I fracture-dislocation secondary to birth trauma, with anterior radial head dislocation and plastic deformation of the ulna. Uniplanar external fixation was used to restore ulnar length and correct angulation, with subsequent radiocapitellar joint closed reduction. Joint congruity was maintained at the 2-year follow-up, with articular remodeling shown on serial arthrogram.