Late Flexor Entrapment in Neocortex After Pediatric Forearm Fracture: A Case Report.

Journal: JBJS Case Connector

Case: A pediatric patient sustained an open Monteggia-equivalent fracture treated operatively. Despite uneventful fracture healing, late-onset extrinsic flexor tightness of the index finger occurred. A neocortex developed about the torn ulnar periosteum, entrapping the index flexor digitorum profundus muscle belly. Despite being 5 years postinjury, motion was improved after proximal muscle release.

Conclusion: Acute flexor entrapment is well-reported in forearm fractures; however, late-onset entrapment inside a neocortex is not. Although early recognition of restricted motion is ideal, even long-standing contractures may be amenable to improvement with appropriate treatment guided by the physical examination.