Complex fracture-dislocations of the proximal ulna and radius in adults: a comprehensive classification

Giannicola, Giuseppe; Greco, Alessandro; Sacchetti, Federico; Cinotti, Gianluca; Nofroni, Italo; Postacchini, Franco

doi:10.1016/j.jse.2011.06.003

Cited by 22 publications

(15 citation statements)

References 42 publications

(88 reference statements)

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“…Monteggia [9] was the first to describe this lesion. Later Bado [2], Chick and Court [4] as well as Giannicola [7] described classification systems for the fracture dislocation of the proximal forearm. Again, these classifications are limited to one type of lesion.…”

Section: Discussionmentioning

confidence: 99%

Proximal ulna fractures

Nijs

Hackl

Devriendt³

2014

Obere Extremität

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Section: Discussionmentioning

confidence: 99%

Proximal ulna fractures

Nijs

Hackl

Devriendt³

2014

Obere Extremität

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“…Surgical records were analyzed by a trained Orthopaedic surgeon (C.G), investigating concomitant bony lesions and ligamentous injuries, use of cementation, associated surgical procedures and intraoperative complications such as massive bleeding or residual instability of the elbow. The preoperative CT scans and plain radiographs were investigated separately by two residents in Orthopaedic Surgery (A.N/M.M) allowing to identify the pattern of radial head fracture according to modified Mason classification [11], presence of coronoid fracture or other patterns of ulnar fractures [12,13]; any discordances were discussed and solved by the senior author (F.C). Patients were subsequently convened to the follow-up evaluation.…”

Section: Methodsmentioning

confidence: 99%

Acute radial head replacement with bipolar prostheses: midterm results

Nosenzo

Galavotti

Menozzi

et al. 2020

Eur J Orthop Surg Traumatol

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In irreparable radial head fractures, especially if primary stabilizers of the elbow are damaged, the prosthetic replacement prevents instability and stiffness. Concerns have arisen over the use of bipolar press-fit prostheses due to the frequent finding of osteolysis and the risk of instability if compared to monopolar implants. Our aim was to assess midterm clinical and radiological outcomes of bipolar implants and the influence of osteolysis on proximal pain. Seventeen patients with irreparable fractures of the radial head, treated in acute with the same prosthetic model (rHEAD recon SBI/Stryker) between January 2015 and December 2018, were enrolled. Clinical assessment was performed using MEPS and DASH scores; a radiographic study was done to identify heterotopic ossifications and periprosthetic osteolysis. Outcomes at the last follow-up, according to MEPS, were excellent in 10 cases, good in 5 and fair in 2; none of the patients had severe pain or instability. In 3 cases, it was necessary to remove the implant, mainly because of early loosening. Radiological findings of osteolysis were detected in 9 cases, but no statistical correlation was found with MEPS and proximal pain. The use of bipolar implants is reliable if an accurate repair of ligament tears is performed and provides a good stability. Nevertheless, the risk of early aseptic loosening in uncemented implants is not negligible, and the follow-up of the patient must be strict. Late osteolysis does not seem to have clinical relevance, but further prospective studies are necessary to clarify this topic.

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“…Application of these eponyms to all injuries accompanied by radiocapitellar dislocation and subluxation has brought about many confusions 8 , such as the anterior olecranon fracture‐dislocation with anterior Monteggia fractures, and the posterior olecranon fracture‐dislocation (posterior fracture‐dislocation of the proximal ulna) with posterior Monteggia fractures. Based on the study by Giannicola 9 . these injuries involve six basic lesions which shall be recognized and well‐treated: (i) ulnar fracture; (ii) radio‐humeral dislocation; (iii) ulnohumeral dislocation; (iv) proximal radio‐ulnar dislocation; (v) radial fracture; and (vi) distal radio‐ulnar joint dislocation or interosseus membrane lesion.…”

Section: Introductionmentioning

confidence: 99%

Difference Between Posterior Monteggia Fractures and Posterior Fracture‐Dislocation of Proximal Ulna in Adults

Liu

Zhang

Wang

et al. 2020

Orthopaedic Surgery

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Objective: To figure out the difference between patients with posterior Monteggia fractures which were concomitant with proximal radioulnar joint (PRUJ) dislocation and posterior fracture-dislocation of the proximal ulna that were not concomitant with PRUJ. Methods: From January 2016 to January 2019, 37 consecutive adult patients who had posterior fracture-dislocation of proximal ulna (no PRUJ dislocation, n = 16) and posterior Monteggia fractures (PRUJ dislocation, n = 21) were included. All patients had intraoperative fluoroscopy, computed tomography (CT) scans, and standard radiography (anteroposterior view and lateral view). The mechanism of injury, the cases with open fracture, sustained multiple injuries and classification of fracture was recorded. The clinical details of the patients such as the final range of motion (ROM) and the Broberg-Morrey scores were described. Results: Patients with PRUJ dislocation (ten type A, five type B, and six type D) and those without concomitant PRUJ dislocation (fifteen type A and one type C) exhibited an obvious difference according to the classifications of Jupiter et al. (P = 0.010). Ninety-five percent of patients who had PRUJ dislocation were accompanied by a metaphyseal fracture, while only 50% of the patients who did not have PRUJ dislocation were accompanied by a metaphyseal fracture (P = 0.002). Meanwhile, 16 of 20 metaphyseal fractures had more than one fragment in the group of dislocations, but five of eight metaphyseal fractures were comminuted in the control group. The two groups exhibited an obvious difference (P = 0.009). The 21 patients who sustained a radioulnar dislocation had less mean arc of flexion, pronation, and Broberg-Morrey scores were significantly less than the patients of the control group (flexion: 117.

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Complex fracture-dislocations of the proximal ulna and radius in adults: a comprehensive classification

Cited by 22 publications

References 42 publications

Proximal ulna fractures

Proximal ulna fractures

Acute radial head replacement with bipolar prostheses: midterm results

Difference Between Posterior Monteggia Fractures and Posterior Fracture‐Dislocation of Proximal Ulna in Adults

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