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A very rare presentation of reoperation combined both old Monteggia fracture and secondary distal radioulnar joint dislocation in adult: A case report

RATIONALE: The old Monteggia fracture is an uncommon lesion pattern in adult, which may lead to the potential complications such as recurrent dislocation of the radial head, heterotopic ossification of the elbow, nerve palsy, malunion of the ulna, and residual forearm deformity. However, the seconda...

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Autores principales: Zhang, Yanchao, Xiao, Wan’an, Li, Jianjun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6494213/
https://www.ncbi.nlm.nih.gov/pubmed/31008984
http://dx.doi.org/10.1097/MD.0000000000015310
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author Zhang, Yanchao
Xiao, Wan’an
Li, Jianjun
author_facet Zhang, Yanchao
Xiao, Wan’an
Li, Jianjun
author_sort Zhang, Yanchao
collection PubMed
description RATIONALE: The old Monteggia fracture is an uncommon lesion pattern in adult, which may lead to the potential complications such as recurrent dislocation of the radial head, heterotopic ossification of the elbow, nerve palsy, malunion of the ulna, and residual forearm deformity. However, the secondary distal radioulnar joint (DRUJ) dislocation is rarely reported in the similar lesion. Here we present a unique reoperation of old Monteggia fracture combined with secondary DRUJ disruption after the initial operation failure. PATIENT CONCERNS: A 38-year-old male presented to our hospital outpatient office complaining of left elbow stiffness and ongoing wrist dysfunction with a history of injury to the left forearm caused by a forklift accident that occurred 5 months previously. DIAGNOSIS AND INTERVENTIONS: At the local hospital, the patient underwent successively fasciotomy and decompression, ulnar open reduction, and internal fixation due to osteofascial compartment syndrome and a misdiagnosed ulnar fracture. Upon examination, the secondary dorsal dislocation of the DRUJ was obvious both clinically and radiographically. We performed a revision surgery called ulnar osteotomy, radioulnar ligament repair, and temporary fixation of the DRUJ with a Kirschner wire. OUTCOMES: The patient received a satisfactory result without observed redislocation and relapse according to the 1-year follow-up. LESSONS: Considering the notoriously poor outcomes, the importance of early recognition and accurate treatment should be emphasized repeatedly in similar lesions. Paying close and continuous attention to the clinical and radiographic examinations of the elbow and wrist joint is necessary to avoid misdiagnosis and missed diagnosis.
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spelling pubmed-64942132019-05-29 A very rare presentation of reoperation combined both old Monteggia fracture and secondary distal radioulnar joint dislocation in adult: A case report Zhang, Yanchao Xiao, Wan’an Li, Jianjun Medicine (Baltimore) Research Article RATIONALE: The old Monteggia fracture is an uncommon lesion pattern in adult, which may lead to the potential complications such as recurrent dislocation of the radial head, heterotopic ossification of the elbow, nerve palsy, malunion of the ulna, and residual forearm deformity. However, the secondary distal radioulnar joint (DRUJ) dislocation is rarely reported in the similar lesion. Here we present a unique reoperation of old Monteggia fracture combined with secondary DRUJ disruption after the initial operation failure. PATIENT CONCERNS: A 38-year-old male presented to our hospital outpatient office complaining of left elbow stiffness and ongoing wrist dysfunction with a history of injury to the left forearm caused by a forklift accident that occurred 5 months previously. DIAGNOSIS AND INTERVENTIONS: At the local hospital, the patient underwent successively fasciotomy and decompression, ulnar open reduction, and internal fixation due to osteofascial compartment syndrome and a misdiagnosed ulnar fracture. Upon examination, the secondary dorsal dislocation of the DRUJ was obvious both clinically and radiographically. We performed a revision surgery called ulnar osteotomy, radioulnar ligament repair, and temporary fixation of the DRUJ with a Kirschner wire. OUTCOMES: The patient received a satisfactory result without observed redislocation and relapse according to the 1-year follow-up. LESSONS: Considering the notoriously poor outcomes, the importance of early recognition and accurate treatment should be emphasized repeatedly in similar lesions. Paying close and continuous attention to the clinical and radiographic examinations of the elbow and wrist joint is necessary to avoid misdiagnosis and missed diagnosis. Wolters Kluwer Health 2019-04-19 /pmc/articles/PMC6494213/ /pubmed/31008984 http://dx.doi.org/10.1097/MD.0000000000015310 Text en Copyright © 2019 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0
spellingShingle Research Article
Zhang, Yanchao
Xiao, Wan’an
Li, Jianjun
A very rare presentation of reoperation combined both old Monteggia fracture and secondary distal radioulnar joint dislocation in adult: A case report
title A very rare presentation of reoperation combined both old Monteggia fracture and secondary distal radioulnar joint dislocation in adult: A case report
title_full A very rare presentation of reoperation combined both old Monteggia fracture and secondary distal radioulnar joint dislocation in adult: A case report
title_fullStr A very rare presentation of reoperation combined both old Monteggia fracture and secondary distal radioulnar joint dislocation in adult: A case report
title_full_unstemmed A very rare presentation of reoperation combined both old Monteggia fracture and secondary distal radioulnar joint dislocation in adult: A case report
title_short A very rare presentation of reoperation combined both old Monteggia fracture and secondary distal radioulnar joint dislocation in adult: A case report
title_sort very rare presentation of reoperation combined both old monteggia fracture and secondary distal radioulnar joint dislocation in adult: a case report
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6494213/
https://www.ncbi.nlm.nih.gov/pubmed/31008984
http://dx.doi.org/10.1097/MD.0000000000015310
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