1/7. Comminuted Monteggia fracture-dislocation--a technique for restoration of ulnar length: case reports.A technique to aid the reconstruction of the ulna in case of comminuted Monteggia fracture-dislocation is presented. This involves reducing the proximal radioulnar joint and temporarily transfixing the radial head to the ulna by 1 or 2 Kirschner (K) wires to establish the ulnar length. Once ulnar length has been defined, reconstruction of the comminuted ulna fracture is simplified. The radioulnar K-wires are then removed and the radioulnohumeral joint is tested for stability. This technique has been used in 6 cases of type-1 Monteggia fracture-dislocation with no subsequent malunion of the ulnar fracture or redislocation' of the radial head. After an average of 13 months follow-up, all patients had nearly full range of motion of the elbow joint.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
2/7. Three epiphyseal fractures (distal radius and ulna and proximal radius) and a diaphyseal ulnar fracture in a seven-year-old child's forearm.SUMMARY: The authors report a rare case of fracture separations at both ends of the radius combined with an epiphyseal and diaphyseal fracture of the ipsilateral ulna. A seven-year-old girl fell one story and sustained a closed injury of her forearm. A closed reduction was unsuccessful, and an open reduction was performed with three of the four fractures being secured with Kirschner wires. These wires were removed one month later, and range-of-motion exercises were started. Thirty months after surgery, both forearms were equal in length, although the proximal radial epiphyseal line appeared partially closed. Joint motions, including forearm rotation, were normal. Radiologically, the ulnar diaphysis and the radial neck were posteriorly convex 20 degrees and 18 degrees, respectively.- - - - - - - - - - ranking = 2keywords = motion (Clic here for more details about this article) |
3/7. Combined Monteggia and Galeazzi fractures in a child: a case report and review of the literature.We present an unusual case in which a combination of Monteggia and Galeazzi fractures occurred in the same forearm. The patient was a 10-year-old male who climbed up the pole of a basketball net, caught hold of the net, then lost his grip, and fell onto his right hand. On physical examination, a complete paralysis of the radial ulnar and median nerves was recognized. x-rays showed an olecranon fracture and lateral dislocation of the radial head in the elbow joint, a dorsal dislocation of the distal bone fragments due to a fracture of the distal third of the radius, and a palmar dislocation of the distal end of the ulna at the wrist joint. The injuries were diagnosed as a combination of a Bado type III Monteggia fracture and a palmar-type Galeazzi fracture of the same arm. Manual reduction and immobilization in a plaster cast were performed. Three years after the injury, both the distal and proximal radioulnar joints were maintained in the reduction position. Range of motion was reduced minimally in extension at the patient's elbow, and there was complete recovery of all three nerves. A combination of Monteggia and Galeazzi fractures in the same arm has been reported in only two pediatric patients worldwide and in eight cases total when adult patients are included, indicating that this is an extremely rare trauma.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
4/7. Unsuspected "isolated" dislocation of the radial head in an adult.We have described a patient who as a child sustained a monteggia's fracture that was neither diagnosed nor treated. Neurologic deficit and limitation of motion were clinically apparent. A high index of suspicion, careful examination of the patient, and high-quality roentgenograms should enable accurate diagnosis of this and similar lesions in less obvious cases, thus avoiding the complications of missed diagnosis.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
5/7. Lateral condylar fracture and ipsilateral ulnar shaft fracture: Monteggia equivalent lesions?Displaced ulnar shaft fractures are frequently associated with radiohumeral dislocation, producing the Monteggia fracture-dislocation. Fractures not previously thought to coexist were seen in a young boy following a severe automobile-pedestrian accident. The displaced ulnar shaft fracture was associated with a displaced lateral condylar fracture with preservation of the radiocapitellar joint and capsule. This fracture was treated with rigid internal fixation in spite of the open nature of the ulnar shaft fracture. This treatment permitted early range of motion of the elbow with early use of ambulatory aids for other associated injuries and an excellent follow-up at 13 months with a normal range of motion of the elbow.- - - - - - - - - - ranking = 2keywords = motion (Clic here for more details about this article) |
6/7. Surgical treatment of symptomatic chronic radial head dislocation: a neglected Monteggia fracture.The treatment of the uncommon symptomatic and neglected Monteggia fracture-dislocation of childhood can pose a significant clinical problem because of pain, decreased range of motion, unstable cubitus valgus, and possible nerve damage. This unusual injury is presented with a detailed description of a modified Bell Tawse annular ligament reconstruction. The modifications of the procedure simplify it and more closely duplicate the anatomy of the annular ligament. This procedure is indicated in the treatment of the symptomatic and neglected Monteggia fracture-dislocation of childhood.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
7/7. Treatment of posttraumatic radioulnar synostosis with excision and low-dose radiation.Two cases of posttraumatic radioulnar synostosis treated with excision and low-dose radiation are presented. Routine postoperative hand therapy was employed. Nearly full range of motion was restored in both cases. No wound healing problems were encountered. We suggest that low-dose radiation may be a useful method of prophylaxis against recurrence after excision of radioulnar synostosis.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |