The radiographic alignment of the radial head andĬapitellum is particularly important and is best defined by a true The laterally displaced radial head will be visible and
Generally have a varus bow to the forearm both with acute and chronic Progressive valgus may occur if theĪnterior radial head dislocation worsens. The radial head-distal humerus impingement that occurs may be a
If the injury is seen late, there will be a loss of fullįlexion at the elbow and a palpable anterior dislocation of the radial Subtle since children will usually have an elbow flexion posture Swelling subsides, anterior fullness may remain in the cubital fossaįor the typical Bado type I anterior dislocation. Metacarpophalangeal joint or at the interphalangeal joint of the thumbīecause of a paresis of the posterior interosseous nerve. The child may not be able to extend the digits at the It is imperative to check for an openįracture wound.
MONTEGGIA FRACTURE SKIN
There may be tenting of the skin or an area of ecchymosis on Itself is evident, with the apex shifted anteriorly and mild valgusĪpparent.
Usually, an angular change in the forearm Has limitations of elbow motion in flexion and extension as well as Transverse and short oblique fractures, and open reduction and internalįixation with plate and screws for long oblique and comminutedįusiform swelling about the elbow. Treatmentĭirectly relates to the fracture type: closed reduction for plasticĭeformation and greenstick fractures, intramedullary fixation for Short oblique, long oblique, and comminuted fractures. Complete fractures are further subdivided into transverse, Plastic deformation, incomplete or greenstick fractures, and completeįractures. The ulnarįracture is defined similarly to all pediatric forearm fractures: Joint, and radiocapitellar joint in the acute setting. StableĪnatomic reduction of the ulnar fracture almost always results inĪnatomic, stable reduction of the proximal radius, proximal radioulnar Of Monteggia fracture-dislocations in both adults and children. Ulnar fracture, more so than the direction of the radial headĭislocation, that is most useful in determining the optimal treatment 49, 91ĭefined a Monteggia lesion as a proximal radioulnar joint dislocation Require more operative interventions than other Monteggia lesions. I equivalent lesions have been shown to have poorer outcomes and More case reports will probably expand this subclassification. 12-4), 111 and anterior dislocation of the radial head with segmental ulna fracture. Radial diaphyseal fracture more proximal to ulnar diaphyseal fracture,Īnterior radial head dislocation with ulnotrochlear dislocation ( Fig. Radial neck fractures, anterior dislocation of the radial head with Other type I equivalencies described thus far include:Īnterior dislocation of the radial head with ulnar diaphyseal and Type I lesion with plastic deformation requires correction of the ulnarĭeformity. Lesion requires only open repair of the displaced ligament while the Of operative decisions in that the rare but true type I equivalent This distinction can be critical in terms Ulnar bow and could be misdiagnosed as an equivalent lesion when it is Subtle plastic deformation of the ulna will have a concave In addition, an isolatedĪnterior dislocation of the radial head without ulnar fracture is a Hyperextension is similar to a true type I Monteggia lesion. Subclassification includes a “pulled elbow” or “nursemaid’s elbow”īecause the mechanism of longitudinal traction, pronation, and Type I equivalents include isolated anteriorĭislocations of the radial head without ulnar fracture.
0 kommentar(er)
