Case Report A Rare Variety of Type 4 Monteggia Fracture Dislocation in A 28 Years Old Man英文文献资料.docVIP

Open Journal of Orthopedics, 2012, 2, 47-50 47 /10.4236/ojo.2012.22009 Published Online June 2012 (http://www.SciRP.org/journal/ojo) Case Report: A Rare Variety of Type 4 Monteggia Fracture Dislocation in a 28 Years Old Man Ranadeb Bandyopadhyay , Arindam Mukherjee 1* 2 1 Department of Orthopaedics, Bankura Sammilani Medical College, Bankura, India; 2 Bankura Sammilani Medical College, Bankura, India. * Email: ranadeb.b@, arindamm02@ Received March 6 , 2012; revised April 20 , 2012; accepted May 8 , 2012 th th th ABSTRACT A Monteggia fracture is a fracture of the proximal ulna coupled with a radial head dislocation. Numerous classification systems have been developed to characterize these fractures. Bado classification is most commonly used. Bado type 1 Monteggia fractures are most common while type 3 4 are rare entities. In our case, after confirming the diagnosis as type 4 Bado Monteggia fracture dislocation, patient was posted for open reduction and internal fixation. The ulnar and radial fractures were rigidly fixed with 3.5 compression plate and ulnar length restored. However, the radial head was still found to be dislocated anteriorly on fluoroscopy. An attempt of closed reduction of the radial head failed. Open reduction of the radial head was performed under image intensifier and fixed with a Kirschner’s wire followed by im- mobilization in hyperflexion for 2 weeks. The patient followed up at the end of 2 weeks, 4 weeks and 6 weeks follow- ing injury and gradual mobilisation of the elbow joint was made. Further follow up at 6 months and 1 year showed complete return of routine function. As soon as the ulnar length is restored by rigid internal fixation, radial head is itself reduced in majority of Monteggia fracture dislocation where only ul