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Italian twins: Monteggia and galeazzi fractures
Case presentation
A 4-year-old male presents with right forearm pain after falling while in a “bouncy house.” Apparently, the child was in the house with several other children and had a witnessed fall onto the arm. The parents noted that he had swelling to his right elbow. There is no other reported injury, and Emergency Medical Services applied a temporary splint and gave the child intranasal fentanyl (2 μg/kg) for pain management.
His physical examination is significant for right elbow pain and swelling. He has limited range of motion of the forearm at the elbow but he does not appear to have shoulder, upper arm, wrist, hand, or digit injury. He is grossly neurovascularly intact.
Imaging considerations
Plain radiography
Plain radiography is an appropriate imaging modality to utilize in patients with suspected skeletal injury. It is important to obtain adequate imaging, which includes anterior-posterior (AP) and lateral views of the entire forearm and elbow (important for suspected Monteggia fracture) and wrist (important for suspected Galeazzi fracture). ,
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