LATERAL HUMERAL CONDYLAR FRACTURE IN A PAEDIATRIC MONTEGGIA TYPE III EQUIVALENT
Keywords:
Monteggia, lateral condyle, Monteggia equivalent, Barzulla circle
Abstract
Monteggia fracture dislocations can be classic or equivalents. Equivalents, also known as Monteggia like lesions, are very rare especially type III and IV, which have been added to the literature after Luis Bado presented the original classification system of Monteggia fracture dislocations. Type III equivalent is classically defined as a proximal ulna fracture associated with a fracture of the lateral condyle of the humerus. In the literature only seven such cases have been reported so far. Here we present two such cases where one eight-year-old boy had a complex type of injury with a shear type fracture of the lateral humeral condyle and other a seven-year-old boy who had a plastic deformity of the ulna with an avulsion type fracture of the lateral humeral condyle. We also try to describe a novel mechanism of injury, known as, “Barzulla circle”, for the classical as well as equivalent type III Monteggia fracture dislocations.
References
[1] Delpont M, Louahem D, Cottalorda J. Monteggia injuries. Orthop Traumatol Surg Res 2018;104(1S): S113-S120.
[2] Rodriguez-Merchan EC. Pediatric fractures of the forearm. Clin Orthop Relat Res 2005;(432):65-72.
[3] Jangir R. Monteggia equivalents: report of a new variant of Type-I Salter Harris Type One Injury to Proximal Radius Physis and Oleconon Fracture. J Ortho Bone Disord 2017;1(5):000128.
[4] Ravessoud FA. Lateral condylar fracture and ipsilateral ulnar shaft fracture: Monteggia equivalent lesions? J Pediatr Orthop 1985;5(3):364-366.
[5] Singh A, Kumar R, Ranjan R, Ahmad S. Missed monteggia dislocation with plastic deformation of ulna. Int J Orthop Sci 2017;3(3):309-312.
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[7] Bado JL. The Monteggia lesion. Clin Orthop 1967;50: 71.
[8] Arazi M, Ogun TC, Kapicioglu MI. The Monteggia lesion and ipsilateral Supracondylar humerus and distal radius fractures. J Orthop Trauma 1999;13(1):60-63.
[9] Eglseder WA, Zadnik M. Monteggia fractures and variants: review of distribution and nine irreducible radial head dislocations. South Med J 2006;99(7):723-727.
[10] Beutel BG. Monteggia fractures in pediatric and adult populations. Orthopaedics 2012:35(2):138-44.
[11] Wright P. Greenstick fracture of the upper end of the ulna with dislocation of the radio-humeral joint or displacement of the superior radial epiphysis. J Bone Joint Surg Br 1963;45: 727-731.
[12] Park Jh, Suh SW. Ipsilateral monteggia fracture and lateral condyle fracture of the humerus in children. J Korean Soc Fract 1997;10: 708.
[13] Guven M, Eren A, Kadioglu B, Yavuz U, Kilincoglu V, Ozkan K. The results of treatment in pediatric Monteggia Equivalent lesions. Acta Orthop Traumatol Turc 2008;42: 90-96.
[14] Dattani R, Patnaik S, Kantak A, Lal M. Distal humerus lateral condyle fracture and Monteggia lesion in a 3-year-old lesion: A case report. Acta Orthop Belg 2008;74: 542-545.
[15] Bugeja M, Avakyan A, Bianco E, Azzopardi T. Type III Monteggia Equivalent Lesion with Ipsilateral Fracture Lateral Condyle of Humerus in a Four-year-old Child: A Case Report and Literature Review. J Orthop Case Rep 2018;8(5):19-21.
[16] Song KS, Bae KC. Type III Monteggia equivalent fracture with ipsilateral distal radial epiphyseal and ulnar metaphyseal fracture in a child-case report. J Korean Orthop Assoc 2004;39(5):563-565.
[17] Shaan ZH, Faizan M, Jilani LZ, Asif N, Ahmad S, Abbas M. A new Monteggia equivalent injury pattern with type I epiphyseal separation of proximal radius – a case report. Int J Curr Res 2017;9(08):55879-55881.
[18] Muzaffar N, Singh S, Bashir N, Malik T, Malik R, Hafeez A. Conaomitant ulanr shaft and humeral condylar fracture in a 6-year-old child. WMC Orthop 2011;2(3): WMC001762.
[19] Sinha S, Chang W, Campbell S, Hussein S. Type III Monteggia injury with ipsilateral distal radius and ulna fracture. Int J Orthop Surg 2002;1(1): e1-e4.
[20] Anshuman R, Aggarwal AN, Pandey R, Mishra P, Yeptho P. Type III Monteggia equivalent injury with compartment syndrome in a 8 year old child: A case report. J Clin Orthop Trauma 2019;10: 800-803.
[21] Biyani A. Ipsilateral Monteggia equivalent injury and distal radial and ulnar fracture in a child. J Orthop Trauma 1994;8(5):431-433.
[22] Inoue T, Kubota M, Maruma K. A type III Monteggia injury with ipsilateral fracture of the distal radius and ulna in a child: case report followed for 21 years. Case Rep Orthop 2018;2018: 1876075.
[23] Kamudin N, Firdouse M, Han CS, Yusof A. Variants of Monteggia Type injury: Case Reports. Malays Orthop J 2015;9(1):23027.
[2] Rodriguez-Merchan EC. Pediatric fractures of the forearm. Clin Orthop Relat Res 2005;(432):65-72.
[3] Jangir R. Monteggia equivalents: report of a new variant of Type-I Salter Harris Type One Injury to Proximal Radius Physis and Oleconon Fracture. J Ortho Bone Disord 2017;1(5):000128.
[4] Ravessoud FA. Lateral condylar fracture and ipsilateral ulnar shaft fracture: Monteggia equivalent lesions? J Pediatr Orthop 1985;5(3):364-366.
[5] Singh A, Kumar R, Ranjan R, Ahmad S. Missed monteggia dislocation with plastic deformation of ulna. Int J Orthop Sci 2017;3(3):309-312.
[6] Rehim SA, Maynard MA, Sebastin SJ, Chung KC. Monteggia fracture-dislocations: A historical review. J Hand Surg Am 2014;39(7):1384-1394.
[7] Bado JL. The Monteggia lesion. Clin Orthop 1967;50: 71.
[8] Arazi M, Ogun TC, Kapicioglu MI. The Monteggia lesion and ipsilateral Supracondylar humerus and distal radius fractures. J Orthop Trauma 1999;13(1):60-63.
[9] Eglseder WA, Zadnik M. Monteggia fractures and variants: review of distribution and nine irreducible radial head dislocations. South Med J 2006;99(7):723-727.
[10] Beutel BG. Monteggia fractures in pediatric and adult populations. Orthopaedics 2012:35(2):138-44.
[11] Wright P. Greenstick fracture of the upper end of the ulna with dislocation of the radio-humeral joint or displacement of the superior radial epiphysis. J Bone Joint Surg Br 1963;45: 727-731.
[12] Park Jh, Suh SW. Ipsilateral monteggia fracture and lateral condyle fracture of the humerus in children. J Korean Soc Fract 1997;10: 708.
[13] Guven M, Eren A, Kadioglu B, Yavuz U, Kilincoglu V, Ozkan K. The results of treatment in pediatric Monteggia Equivalent lesions. Acta Orthop Traumatol Turc 2008;42: 90-96.
[14] Dattani R, Patnaik S, Kantak A, Lal M. Distal humerus lateral condyle fracture and Monteggia lesion in a 3-year-old lesion: A case report. Acta Orthop Belg 2008;74: 542-545.
[15] Bugeja M, Avakyan A, Bianco E, Azzopardi T. Type III Monteggia Equivalent Lesion with Ipsilateral Fracture Lateral Condyle of Humerus in a Four-year-old Child: A Case Report and Literature Review. J Orthop Case Rep 2018;8(5):19-21.
[16] Song KS, Bae KC. Type III Monteggia equivalent fracture with ipsilateral distal radial epiphyseal and ulnar metaphyseal fracture in a child-case report. J Korean Orthop Assoc 2004;39(5):563-565.
[17] Shaan ZH, Faizan M, Jilani LZ, Asif N, Ahmad S, Abbas M. A new Monteggia equivalent injury pattern with type I epiphyseal separation of proximal radius – a case report. Int J Curr Res 2017;9(08):55879-55881.
[18] Muzaffar N, Singh S, Bashir N, Malik T, Malik R, Hafeez A. Conaomitant ulanr shaft and humeral condylar fracture in a 6-year-old child. WMC Orthop 2011;2(3): WMC001762.
[19] Sinha S, Chang W, Campbell S, Hussein S. Type III Monteggia injury with ipsilateral distal radius and ulna fracture. Int J Orthop Surg 2002;1(1): e1-e4.
[20] Anshuman R, Aggarwal AN, Pandey R, Mishra P, Yeptho P. Type III Monteggia equivalent injury with compartment syndrome in a 8 year old child: A case report. J Clin Orthop Trauma 2019;10: 800-803.
[21] Biyani A. Ipsilateral Monteggia equivalent injury and distal radial and ulnar fracture in a child. J Orthop Trauma 1994;8(5):431-433.
[22] Inoue T, Kubota M, Maruma K. A type III Monteggia injury with ipsilateral fracture of the distal radius and ulna in a child: case report followed for 21 years. Case Rep Orthop 2018;2018: 1876075.
[23] Kamudin N, Firdouse M, Han CS, Yusof A. Variants of Monteggia Type injury: Case Reports. Malays Orthop J 2015;9(1):23027.
Published
2021-02-24
How to Cite
[1]
N. Ali, A. Kawoosa, M. Mumtaz, and F. Lone, “LATERAL HUMERAL CONDYLAR FRACTURE IN A PAEDIATRIC MONTEGGIA TYPE III EQUIVALENT”, JSS, vol. 7, no. 4, pp. 139-144, Feb. 2021.
Section
Articles
