A Monteggia variant associated with unusual fracture of radial head in a young child: A case report

Abstract

Introduction: Monteggia fracture and its variants are not common among children but may be challenging and lead to serious complications if not treated in acute stage. The different types of associated growth plate fractures of proximal radius are not yet clearly defined in any variant classifications.

Presentation of case: A 6-year-old girl was brought to the emergency room after a fall on the left elbow. The plain radiographs showed unstable fracture of proximal ulna with a laterally displaced and comminuted radial head fracture. The patient was treated surgically as a case of a Monteggia variant. The case has been re-evaluated twenty months following the surgery and did not show any radiological signs of growth disturbance nor residual deformity.

Discussion: The presented Monteggia variant is rare in terms of associated unique intra-articular fracture of proximal radius. The successful management of the case is based on adhering to the principles of treatment of Monteggia fractures.

Conclusion: Early recognition of unusual Monteggia variant patterns is crucial to avoid delay in treatment. Adherence to the principles of surgical management in unstable variants is encouraged.

Keywords: Case report; Monteggia equivalent; Monteggia fracture; Monteggia variant; Radial head; Salter Harris.