背景:Monteggia骨折,定义为尺骨近端三分之一的骨折,与近端桡骨骨phy的前脱位或后脱位有关,是一种严重损伤,占成人所有肘部骨折和脱位的0.7%。对于成年患者,只有通过早期诊断和适当的手术治疗才能获得良好的效果。与肱骨远端骨折相关的Monteggia骨折脱位在成人中极为罕见,文献中描述的病例很少。这些条件引起的医疗法律影响具有许多不可忽视的复杂性。
方法:本病例报告围绕一名患有I型Monteggia骨折脱位的患者,根据Bado分类,伴有同侧肱骨远端髁间骨折。据我们所知,这种病变组合在成年患者中从未报道过.由于早期诊断,获得了阳性结果,解剖减少的成就,和最佳的稳定与内固定,这使得有可能实现早期功能恢复。
结论:与同侧肱骨远端髁间骨折相关的Monteggia骨折脱位在成人中极为罕见。在本文报告的情况下,由于早期诊断,获得了良好的结果,用钢板和螺钉内固定实现解剖复位和管理,以及早期功能训练。误诊使此类病变具有潜在的延迟治疗风险,增加了对手术干预的需求以及高风险并发症和致残后遗症的可能性,可能涉及医学和法律问题.在紧急情况下无法识别的伤害的情况下,损伤可能会变成慢性的,使治疗更加复杂。误诊的Monteggia病变的最终结果可能导致非常严重的功能和美学损害。
The Monteggia fracture, defined as a fracture of the proximal third of the ulnar shaft associated with an anterior or posterior dislocation of the proximal radial epiphysis, is a serious injury accounting for 0.7% of all elbow fractures and dislocations in adults. For adult patients, good results can only be obtained through early diagnosis and adequate surgical treatment. Monteggia fracture-dislocations associated with distal humeral fracture are extremely rare injuries in adults and there are few cases described in the literature. Medico-legal implications arising from such conditions have a host of complexities that cannot be discounted.
This
case report revolves around a patient affected by a type I Monteggia fracture-dislocation, according to the Bado classification, associated with an ipsilateral intercondylar distal humeral fracture. To our knowledge, this combination of lesions has never been reported before in adult patients. A positive result was obtained due to early diagnosis, achievement of anatomical reduction, and optimal stabilization with internal fixation which made it possible to achieve early functional recovery.
Monteggia fracture-dislocations associated with ipsilateral intercondylar distal humeral fracture are extremely rare in adults. In the
case herein reported, a favorable outcome was obtained due to early diagnosis, achievement of anatomical reduction and management with internal fixation with plate and screws, as well as early functional training. Misdiagnosis makes such lesions risky in terms of potentially delayed treatment, increasing the need for surgical interventions and the possibility of high-risk complications and disabling sequelae, with possible medico-legal implications. In the
case of unrecognized injuries under urgent circumstances, the injuries may become chronic, making the treatment more complex. The ultimate outcomes of a misdiagnosed Monteggia lesion can lead to very serious functional and aesthetic damage.