Growth plate injury is a debilitating condition for children. To our knowledge, there is currently no systematic review regarding the complication of epiphyseal injury. Thus, the authors would like to conduct a systematic review regarding this topic. The following strategy was used: the terms used on the PubMed search engine were “growth plate injuries complications.” Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to perform the comprehensive data collection. The initial PubMed search yielded 341 titles and 81 articles included according to the inclusion criteria, but 20 articles were eliminated according to the exclusion criteria. The final total number of articles was 61. The epiphyseal injury usually ends with a good functional outcome, although some serious complication risk remains.

Monteggia and equivalent lesions are relatively rare but result in severe injuries in childhood, typically affecting children between 4 and 10 years old. The diagnosis and treatment of an equivalent Monteggia lesion is more complicated than those of a typical Monteggia fracture. This type of lesion may be challenging and may lead to serious complications if not treated properly. Pediatric Monteggia equivalent type I lesions have been reported in a few reports, all of which the patients were all over 4 years old.

A 14-mo-old boy was referred to our clinic after falling from his bed 10 d prior. With regard to the clinical examination, an obvious swollen and angular deformity was noted on his right forearm. Plain radiographs and reconstructed computed tomography scans showed a Monteggia type I fracture and dislocation. Magnetic resonance imaging (MRI) confirmed a type I Monteggia equivalent lesion consisting of ulnar fracture and Salter-Harris type I injury in the proximal radius. The radial head was still in the joint, and only the radial metaphysis was displaced anteriorly. Open reduction and pinning of both displaced radial and ulnar fractures achieved an excellent result with full function.

We recommend MRI examination or arthrography during reduction, especially if the secondary ossification center has not appeared.

• Children
• Monteggia fracture-dislocation
• Monteggia equivalent lesion
• Radial neck fracture
• Ulnar fracture
• Case report

• Essex-Lopresti
• Forearm injury
• Galeazzi
• Monteggia

Monteggia equivalent lesion represents a series of combined elbow and forearm injuries that resemble typical Monteggia fracture either in presentation or mechanism. The term has gradually evolved since its introduction, as sporadic case reports continued to complement it. The aim of this study was to present a furthermore type of that lesion which no previous study had reported and arouse pediatric orthopedists’ additional awareness of it.

A 11-year-old girl, whose injury pattern initially appeared to be a mild radial neck fracture with undisplaced proximal ulnar fracture, and without radial head dislocation, was treated with closed reduction and long-arm splint immobilization. Acceptable results were acquired at first-week follow-up, yet dramatic changes turned up 2 weeks later when the dislocated radial head was found. A further reduction to the fracture and joint site only resulted in a subluxated and incongruous radiocapitellar joint on the three-dimensional computed tomography (3D-CT). Then a definitive operation was performed, which involved a Boyd incision, correction of radial head tilting, opening wedge osteotomy of the proximal ulna and proper fixation respectively. And acceptable results were achieved 1 year later.

This case, with occult proximal ulna fracture, angulated radial neck fracture, subsequent radiocapitellar dislocation, and articular incongruity, was deemed as a rare Monteggia type-one equivalent fracture-dislocation variant rather than an ordinary radial neck fracture and it facilitates further understanding and management of the Monteggia fracture.

• Adolescent
• Children
• Monteggia equivalent lesion
• Monteggia fracture
• Radial neck fracture
• Radiocapitellar dislocation