Changes in the Management of Monteggia Fractures

Monteggia Fractures in Childhood?Diagnosis and Management in Acute and Chronic Cases

“…One useful description of the fracture patterns in Monteggia lesions was introduced by José Luis Bado in 1958 [1]. In the last 2 decades, the knowledge about Monteggia lesions in children has significantly improved [42], and the mechanism of injury as well as fracture patterns have increasingly better been understood. It is the aim of this article to provide the state of the art in diagnostics and treatment of Monteggia fractures in childhood.…”

Morphologic Evaluation of Chronic Radial Head Dislocation: Three-dimensional and Quantitative Analyses

“…Open reduction of the radial head along with ulnar osteotomy [8,11,12,15,18,21,30] and reconstruction of the annular ligament [4,6,7,15,24,27,28] have been attempted to maintain congruity of the radiocapitellar joint because prolonged radial head dislocation leads to longterm complications, such as cubitus valgus deformities [6,10,17], osteoarthritis [15,21,22], and posterior interosseous nerve palsy [2,14,23]. However, the surgical outcome was less satisfactory for longstanding cases [9,11,15,16,21,22,24,31,32], and previous studies have revealed reduction of the radial head led to inferior clinical results more than 6 years postinjury [29,32]. Surgical indications for chronic radial head dislocation have been based on radiographic appearances of overgrowth and changes in convexity of the radial head, and on deformities in the humeral capitulum [11,15,21,31,32], but little attention has been paid to the morphologic features of the proximal radioulnar joint (PRUJ), which is considered quite important for reducing the radial head to the correct position.…”

“…Additionally, previous reports have referred only to the radiographic changes in appearance [11,21,22,24,31,32] but not the 3-D size and shape of the radial head, which are crucial for radiocapitellar and radioulnar congruity. In this study, our aim was to observe the morphologic changes of the radial notch of the ulna between affected and unaffected elbows in early-versus longstanding dislocations using 3-D computer bone models created from CT data.…”

“…However, the surgical outcome was less satisfactory for longstanding cases [9,11,15,16,21,22,24,31,32], and previous studies have revealed reduction of the radial head led to inferior clinical results more than 6 years postinjury [29,32]. Surgical indications for chronic radial head dislocation have been based on radiographic appearances of overgrowth and changes in convexity of the radial head, and on deformities in the humeral capitulum [11,15,21,31,32], but little attention has been paid to the morphologic features of the proximal radioulnar joint (PRUJ), which is considered quite important for reducing the radial head to the correct position. We believe the anatomy and pathologic changes of the PRUJ in chronic radial head dislocation should be understood and incorporated in the surgical decisionmaking process.…”

Injuries of the proximal radius

“…medianus und radialis, vorwiegend sensibel) hinzu. Durch die Verplumpung des Radiuskopfs kommt es zur Bewegungseinschränkung und auf Dauer zu einer Degeneration des Radiohumeralgelenks wegen zunehmender Inkongruenz zwischen Kopf und Capitulum[43].…”