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Technical Report | Orthopaedic Surgery | India | Volume 13 Issue 7, July 2024 | Rating: 5.7 / 10
Functional Outcome of Monteggia Fracture Treated with Conservative Treatment in a Paediatric Child: A Case Report
Dr. M Aravindan | Dr. Lionel John [2]
Abstract: Background: Monteggia fractures, characterized by a proximal ulna fracture with radial head dislocation, are rare in pediatric patients but present significant diagnostic and treatment challenges. These fractures can be complicated by nerve injuries such as posterior interosseous nerve (PIN) palsy. Case Presentation: A 12 - year - old male sustained a Monteggia fracture with posterior radial head dislocation and subsequently developed PIN palsy after initial conservative management. Under general anesthesia, closed reduction of the radial head was successfully performed, and the forearm was immobilized in a long - arm cast. One month later, the patient exhibited thumb and finger drop. Neurological examination confirmed PIN palsy. Management: The patient underwent intensive physiotherapy, including range of motion exercises, strengthening exercises, and electrical stimulation, along with medical management including steroids and neurotrophic drugs. Regular follow - ups were conducted to monitor fracture healing and nerve recovery. Outcomes: At three months, the patient showed significant improvement in elbow range of motion and finger and thumb extension. By six months, nearly full function of the affected limb was regained with minimal residual weakness. Conclusion: This case highlights the importance of early diagnosis and appropriate management of Monteggia fractures in children. Conservative treatment, including closed reduction, cast immobilization, and comprehensive physiotherapy, can result in favorable outcomes even in cases complicated by nerve injuries such as PIN palsy. Early intervention and targeted rehabilitation are crucial for optimal recovery and function.
Keywords: monteggia fracture, closed reduction, PIN palsy
Edition: Volume 13 Issue 7, July 2024,
Pages: 1583 - 1585