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A case of Neglected radial head dislocation (Monteggia fracture dislocation)

Neglected radial head dislocation
 is currently known as Monteggia fracture dislocation, which is a relatively rare injury observed in approximately 1% of all pediatric forearm fractures.
AP and lateral X rays view of elbow show dislocation of head radius and vulgus deformity of the elbow 

Case presentation 
10 years old case of Monteggia fracture dislocation presented with deformity of elbow in the form of vulgus. He has no pain with minimal limitation of elbow flexion. 
clinical images show full extension with vulgus angle and minimal loss of elbow flexion 

Discussion 
The treatment of an neglected radial
head dislocation in children continues to be a therapeutic challenge. Osteotomy of the proximal ulna with both
angulation and lengthening allows a stable radial head reduction mostly with no necessity of annular ligament
reconstruction. 

Quiz
Would you recommend ulnar osteotomy and radial head reduction or conservative treatment??

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