PMC7751315_01
Preoperative anteroposterior and lateral radiographs (A and B) showing ulnar shaft fracture and dislocation of the radius head.
ORR-12-189-g0002.jpg
PMC7751315_01_ORR-12-189-g0002.jpg
f0001
The patient was diagnosed with a Monteggia fracture (Bado type I) by conventional radiography (Figure 1).
Postoperative anteroposterior and lateral radiographs (A and B); coronal and axial computed tomography (C and D) on the 17th day showing no dislocation of the radial head or abnormal callus formation at the fracture site.
ORR-12-189-g0003.jpg
PMC7751315_01_ORR-12-189-g0003.jpg
f0002
Post-operative imaging on the 17th day showed no dislocation of the radial head or abnormal callus formation (Figure 2).
Clinical findings illustrating the extension lag of the index finger in the resting position (A), which is less pronounced with wrist flexion (B) and more pronounced with wrist extension (C). Extension of the index finger under wrist extension was conducted under general anesthesia due to pain (C).
ORR-12-189-g0004.jpg
PMC7751315_01_ORR-12-189-g0004.jpg
f0003
However, the active extension range of motion of the proximal interphalangeal (PIP) joint and distal interphalangeal (DIP) joint of the index finger was -60  and -30 , respectively, at the 0  wrist position (Figure 3).
Longitudinal (A) and transverse (B) sonogram of the ulnar shaft indicating partial FDP entrapment (yellow arrows) at the fracture site.
ORR-12-189-g0005.jpg
PMC7751315_01_ORR-12-189-g0005.jpg
f0004
An ultrasound (US) scan later confirmed direct partial entrapment of the FDP (Figure 4).
Passive joint mobilization of the right index finger enabling the PIP and DIP joints to extend to 0 .
ORR-12-189-g0006.jpg
PMC7751315_01_ORR-12-189-g0006.jpg
f0005
The patient was placed under general anesthesia, and with the right index finger gradually extended using passive motion, the PIP and DIP joints were extended to 0  (Figure 5).
Range of motion 8 months post-FDP release. The PIP and DIP joints were able to have full range of motion without pain when the wrist position was neutral (A), extended (B), or flexed (C).
ORR-12-189-g0007.jpg
PMC7751315_01_ORR-12-189-g0007.jpg
f0006
The patient had no problems with performing daily activities at the 8-month follow-up, and no other complications were observed (Figure 6).