Posterior Interosseous Nerve Injury From Chronic Monteggia Fracture Dislocation Requiring Nerve Reconstruction
Monteggia fracture-dislocations are rare elbow injuries in the pediatric population. Multiple case reports have described posterior interosseous nerve (PIN) palsies in the setting of Monteggia fracture-dislocations, usually due to stretch neuropraxia. In this report of a Bado Type III Monteggia frac...
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Elsevier
2025-05-01
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| Series: | Journal of the Pediatric Orthopaedic Society of North America |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2768276525000203 |
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| author | John Bartoletta, MD Raymond Tse, MD Suzanne Steinman, MD |
| author_facet | John Bartoletta, MD Raymond Tse, MD Suzanne Steinman, MD |
| author_sort | John Bartoletta, MD |
| collection | DOAJ |
| description | Monteggia fracture-dislocations are rare elbow injuries in the pediatric population. Multiple case reports have described posterior interosseous nerve (PIN) palsies in the setting of Monteggia fracture-dislocations, usually due to stretch neuropraxia. In this report of a Bado Type III Monteggia fracture-dislocations with delayed diagnosis of an entrapped PIN, we highlight the importance of timely diagnosis. Surgical reconstruction using a sural nerve autograft was required when the PIN was found to be entrapped in the radiocapitellar joint and encircling the radial neck. Key Concepts: (1) Monteggia fracture-dislocations are rare elbow injuries in the pediatric population and can be missed. (2) The orthopaedic surgeon should have heightened suspicion for a posterior interosseous nerve palsy in Bado Type III Monteggia fracture-dislocations. (3) If a posterior interosseous nerve palsy is identified at the time of injury and reduction is difficult, we should consider nerve exploration as it may be entrapped in the joint. |
| format | Article |
| id | doaj-art-17bb3f5405314d45bcab47a604a7e2dd |
| institution | OA Journals |
| issn | 2768-2765 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the Pediatric Orthopaedic Society of North America |
| spelling | doaj-art-17bb3f5405314d45bcab47a604a7e2dd2025-08-20T02:14:30ZengElsevierJournal of the Pediatric Orthopaedic Society of North America2768-27652025-05-011110017610.1016/j.jposna.2025.100176Posterior Interosseous Nerve Injury From Chronic Monteggia Fracture Dislocation Requiring Nerve ReconstructionJohn Bartoletta, MD0Raymond Tse, MD1Suzanne Steinman, MD2Department of Orthopaedic Surgery and Sports Medicine, University of Washington, Seattle, WA, USA; Department of Orthopedics and Sports Medicine, Seattle Children's Hospital, Seattle, WA, USADivision of Plastic Surgery, Seattle Children's Hospital, Seattle, WA, USADepartment of Orthopedics and Sports Medicine, Seattle Children's Hospital, Seattle, WA, USA; Corresponding author: Department of Orthopedics and Sports Medicine, Seattle Children's Hospital, OA.9.120.1, PO Box 5371, Seattle, WA 98145-5005, USA.Monteggia fracture-dislocations are rare elbow injuries in the pediatric population. Multiple case reports have described posterior interosseous nerve (PIN) palsies in the setting of Monteggia fracture-dislocations, usually due to stretch neuropraxia. In this report of a Bado Type III Monteggia fracture-dislocations with delayed diagnosis of an entrapped PIN, we highlight the importance of timely diagnosis. Surgical reconstruction using a sural nerve autograft was required when the PIN was found to be entrapped in the radiocapitellar joint and encircling the radial neck. Key Concepts: (1) Monteggia fracture-dislocations are rare elbow injuries in the pediatric population and can be missed. (2) The orthopaedic surgeon should have heightened suspicion for a posterior interosseous nerve palsy in Bado Type III Monteggia fracture-dislocations. (3) If a posterior interosseous nerve palsy is identified at the time of injury and reduction is difficult, we should consider nerve exploration as it may be entrapped in the joint.http://www.sciencedirect.com/science/article/pii/S2768276525000203Monteggia fracture-dislocationPIN palsyNerve reconstruction |
| spellingShingle | John Bartoletta, MD Raymond Tse, MD Suzanne Steinman, MD Posterior Interosseous Nerve Injury From Chronic Monteggia Fracture Dislocation Requiring Nerve Reconstruction Journal of the Pediatric Orthopaedic Society of North America Monteggia fracture-dislocation PIN palsy Nerve reconstruction |
| title | Posterior Interosseous Nerve Injury From Chronic Monteggia Fracture Dislocation Requiring Nerve Reconstruction |
| title_full | Posterior Interosseous Nerve Injury From Chronic Monteggia Fracture Dislocation Requiring Nerve Reconstruction |
| title_fullStr | Posterior Interosseous Nerve Injury From Chronic Monteggia Fracture Dislocation Requiring Nerve Reconstruction |
| title_full_unstemmed | Posterior Interosseous Nerve Injury From Chronic Monteggia Fracture Dislocation Requiring Nerve Reconstruction |
| title_short | Posterior Interosseous Nerve Injury From Chronic Monteggia Fracture Dislocation Requiring Nerve Reconstruction |
| title_sort | posterior interosseous nerve injury from chronic monteggia fracture dislocation requiring nerve reconstruction |
| topic | Monteggia fracture-dislocation PIN palsy Nerve reconstruction |
| url | http://www.sciencedirect.com/science/article/pii/S2768276525000203 |
| work_keys_str_mv | AT johnbartolettamd posteriorinterosseousnerveinjuryfromchronicmonteggiafracturedislocationrequiringnervereconstruction AT raymondtsemd posteriorinterosseousnerveinjuryfromchronicmonteggiafracturedislocationrequiringnervereconstruction AT suzannesteinmanmd posteriorinterosseousnerveinjuryfromchronicmonteggiafracturedislocationrequiringnervereconstruction |