A Novel Variant of Type II Monteggia Equivalent Fracture-Dislocation in Children: A Case Report

Monteggia fracture-dislocations are extremely rare in children. By definition, it is an ulnar shaft fracture with proximal radioulnar joint dislocation. Throughout the years, various equivalents of this entity have been described. In this report, we present a unique case of a type II Monteggia fracture equivalent with an ipsilateral fracture of the proximal radius and olecranon in a child. The patient was a 12-year-old male who presented with a history of a fall on an outstretched hand. The diagnosis was made based on the clinical examination and plain radiographs. We describe the management of this unique fracture and discuss the possible mechanism of injury. We have highlighted a rare combination of injuries. It is crucial to investigate the condition properly in order to avoid missing the diagnosis and to prevent poor outcomes and further unnecessary revision surgeries.

Intestinal malabsorption in cystic fibrosis

An oral solution containing lactulose and L-rhamnose was administered to six patients with cystic fibrosis. Intestinal absorption of both sugars was assessed by measurement of their urinary excretion. The lactulose: L-rhamnose excretion ratio was raised, supporting the hypothesis of an intestinal component to the malabsorption of cystic fibrosis.