Osteotomia da ulna para correção cirúrgica de fratura de Monteggia negligenciada em criança com deformidade plástica da ulna. Relato de caso / Ulna osteotomy for surgical correction of neglected Monteggia fracture in a child with ulna bowing. Case report

Abstract

Abstract
Introduction: Dislocation of the radial head with ulna bowing, when combined, constitutes a rare condition,
and often missed diagnosed. Objective: Report a case of neglected Monteggia fracture in a child with ulna bowing,
treated surgically with reduction and fixation of the radial head, without reconstruction of the annular ligament, and
osteotomy of the ulna. Case Report: A 6-year-old male patient, victim of falling to the ground, was admitted to
the Emergency Department with complaints of pain in his right elbow. The patient was submitted to radiographic
exams of the elbow, interpreted by the physician as normal. Two weeks later, the patient returned with pain, and
radiographic exams of the forearm showed the presence of ulna bowing associated with dislocation of the radial head.
As a treatment, we opted for open reduction and fixation of the radial head with metallic wires, associated with flexion
osteotomy of the ulna. It evolved in the postoperative period with consolidation of the osteotomy, maintenance of the
reduction of the radial head, and recovery of the total range of motion of the elbow and forearm. Conclusion: Pediatric
patients who present with pain in the elbow, due to a fall, should be thoroughly evaluated for the possibility of ulna
bowing associated with dislocation of the radial head. Ulna osteotomy with fixation of the radial head, without reconstruction
of the annular ligament, brought good results in the treatment of neglected Monteggia fracture in a child with ulna bowing. Keywords: Monteggia fracture, Ulna/deformities, Ulna  fractures, Osteotomy, Trauma, Child, Pediatrics