Monteggia equivalent fracture associated with Salter-Harris I fracture of the radial head.

BACKGROUND

Monteggia fracture is an uncommon lesion, which associates ulnar shaft fracture and radial head dislocation. Equivalent Monteggia fracture can occur by associated lesions such as olecranon fracture or radial neck or head fracture.

CASE PRESENTATION: We present the case of a five-year-old girl, right handed, involved in domestic accident falling off a bed and sustained an isolated trauma of the left upper limb. Radiograph showed an unusual case of Monteggia equivalent lesion associating a fracture of the proximal third of the ulna shaft and a growth plate fracture Salter I of the proximal radial physis and anterior displacement of the proximal metaphysis. Management consisted of surgical care by open reduction with intramedullary pinning of the ulnar shaft fracture and osteosuture of the fracture line associated with non-operative management by closed reduction of radial growth plate fracture. Outcome after 24 months was very good without pain, full range of motion and very good healing.

CONCLUSION

Diagnosing rare injuries, such as equivalent Monteggia fracture, necessitates a high index of suspicion and scrutiny of the findings to don't miss the radial head fracture. Anatomic surgical reduction can yield optimal functional outcomes.