Work

Posterior Interosseous Nerve Injury From Chronic Monteggia Fracture Dislocation Requiring Nerve Reconstruction

Year: 2025

Type: article

Abstract: 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.

Source: Journal of the Pediatric Orthopaedic Society of North America

DOI: 10.1016/j.jposna.2025.100176

Authors: John Bartoletta, Raymond Tse, Suzanne Steinman

Institutions: Seattle Children's Hospital, University of Washington

Language: English

Topic: Elbow and Forearm Trauma Treatment

Subfield: Rehabilitation

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,500