Treatment of Monteggia-like-lesion in a young patient
Autor: | Agung Riyanto Budi Santoso, Muhammad Abduh, Felix Cendikiawan, Alva Pribadi, Anindita E. P. Wijaya, Thomas Erwin Christian Junus Huwae |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
medicine.medical_specialty
Supine position Adolescent medicine.medical_treatment Elbow Monteggia fracture Monteggia's Fracture Fracture Fixation Internal 03 medical and health sciences 0302 clinical medicine Forearm Elbow Joint internal fixation Humans Medicine Internal fixation Displacement (orthopedic surgery) 030212 general & internal medicine Clinical Case Report Range of Motion Articular Monteggia-like-lesions Reduction (orthopedic surgery) business.industry Ulna General Medicine medicine.disease Surgery Treatment Outcome medicine.anatomical_structure radial head fracture 030220 oncology & carcinogenesis Female business Research Article |
Zdroj: | Medicine |
ISSN: | 1536-5964 0025-7974 |
Popis: | Introduction: A Monteggia fracture was described initially as a fracture of the proximal third ulna and anterior dislocation of the proximal epiphysis radius.[1] In 1967, Bado discovered “true Monteggia lesions” and classified them into 4 groups.[2] He also used the term “equivalents” or “Monteggia-like-lesions” to describe specific injuries with similar radiographic patterns.[3] This type of fracture is rare and frequently associated with complications, poor functional results, and further operations.[4] Patient concerns: A 16-year-old girl was admitted to our emergency department after a single motorcycle accident. Her main complaint was the pain and swollen of her left elbow. She was reluctant to move her arm due to pain. Diagnosis: Radiograph examination showed a displaced fracture of the left proximal third ulna accompanied by displacement of the left proximal radius. This fracture was similar to the Monteggia type III fracture except for proximal radial disruption that occurred laterally through a Salter-Harris type II fracture. Interventions: The patient underwent surgical debridement, and the forearm was immobilized using a backslap in a supine position and elbow flexion 90o. Open reduction and internal fixation were performed 5 days later. The ulna was reduced and stabilized first using a 3.5 mm one-third tubular plate (ORMED), and internal fixation of the radial epiphysis was done using a 1.6 mm miniplate (Prohealth). Outcomes: After 3 months, the patient showed improvement with the Mayo Elbow Performance Score (MEPS) of 85. She did not complain of any pain and decreased strength. The patient regained 0 to 125o of elbow flexion and 0 to 165o of supination and pronation. Conclusion: Monteggia-like-lesion has many variations in physical and radiograph appearance. Careful evaluation of fracture pattern, identification of injury mechanism, and appropriate treatment planning based on Monteggia fracture treatment principles are mandatory to achieve the patient's best outcome. |
Databáze: | OpenAIRE |
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