Volume 1, Case 15


Monteggia's Injury
Radiology Cases in Pediatric Emergency Medicine
Volume 1, Case 15
Lynette L. Young, MD

A 9 year old male fell off a slide and landed on his outstretched left arm. He now presents to the ED with pain in his left forearm and elbow. There is no history of head trauma. He denies having a headache, and there is no nausea or vomiting. His past medical history is unremarkable.

Exam: Vital signs T37, P76, R20, BP110/73. He is alert and oriented but in obvious discomfort secondary to left arm pain. Pupils are equal and reactive. His left clavicle, shoulder and humerus are nontender. His left hand and wrist (including the anatomic snuffbox) are also nontender. He is tender over the proximal aspect of his left forearm. He is unable to flex, extend, supinate, or pronate at his left elbow. He is able to move all his fingers well. Distally, he is neurovascularly intact. Capillary refill time is 2 seconds. Radiographs of his left forearm and elbow were obtained.

View radiographs.

Forearm

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Elbow

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There is an obvious mid-shaft ulnar fracture. Do you see anything else wrong with the radiographs? Look at the radiographs again.

What is your Dianosis?

Click here for the answers to Case 15

 Loren Yamamoto, 
      MD, MPH Associate Professor of Pediatrics University of Hawaii John A. Burns 
      School of Medicine loreny@hawaii.edu

Volume 1, Case 15

Monteggia's Injury Radiology Cases in Pediatric Emergency Medicine Volume 1, Case 15 Lynette L. Young, MD

Forearm

Elbow

What is your Dianosis?