Figure 3
A 13 years old boy (case 12) with a missed Monteggia lesion after a 7 years interval. (a) Preoperative X-ray. The appearance of the radial head was domed. (b) Preoperative MRI. Axial T1- and T2-weighted images showed the proximal radioulnar joint was dislocated and the appearance of the radial notch (the arrow) was domed; coronal T2-weighted images showed the radial notch of the ulna was severe hyperplasia (the arrow); sagittal T2-weighted images showed the dislocation of the humeroradial joint and the domed radial head (the arrow) with dense fibrous scar tissue. (c) Open reduction and ulnar osteotomy with reconstruction of the annular ligament and a humeroradial pin was undertaken. (d) The radial head dislocated (Grade 5) due to the hyperplastic radial head incongruency with the capitellum and the elbow had osteoarthritic changes posteriorly at 3 years after operation.
