Corrective ulnar osteotomy for malunited anterior Monteggia lesions in children: 12 patients followed for 1-12 years

Inoue, Goro; Shionoya, Kaori

doi:10.3109/17453679809002361

Cited by 74 publications

(81 citation statements)

References 14 publications

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“…Though limited to retrospective series with small cohort sizes, several groups have reported satisfactory clinical and radiographic outcomes following various combinations of annular ligament repair or reconstruction [3,8,32,38], ulnar osteotomy [8,9,18,20,33,37] (with [32,38] or without bone graft; with [8,9,11,13,14,22,32,38] or without [4,20] fixation), and radiocapitellar [4,8] or radioulnar temporary Kirschner wire fixation. Often, as seen in our case, reduction of the radiocapitellar joint is possible only following resection of the interposed capsule, torn annular ligament, and fibrous scar tissue within the proximal radioulnar and radiocapitellar joints and an ulnar diaphyseal osteotomy.…”

Section: Discussionmentioning

confidence: 99%

Persistent Posterior Interosseous Nerve Palsy Associated with a Chronic Type I Monteggia Fracture-Dislocation in a Child: A Case Report and Review of the Literature

Ruchelsman

Pasqualetto

Price

et al. 2008

Hand (New York, N,Y.)

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We present a rare case of persistent complete posterior interosseous nerve palsy associated with a chronic type I Monteggia elbow fracture-dislocation consisting of anterior dislocation of the radial head and malunion of the ulna in an 8-year-old child requiring surgical treatment. Posterior interosseous nerve neuropraxia following acute Monteggia injury patterns about the elbow has been described and is thought to be secondary to traction or direct trauma. The condition typically resolves following successful closed reduction of the radial head. This report describes combined treatment of the nerve and skeletal injury for the chronic type I Monteggia injury. The literature is reviewed, and diagnostic challenges with and treatment options for chronic Monteggia fracture-dislocations in children are discussed.

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Section: Discussionmentioning

confidence: 99%

Persistent Posterior Interosseous Nerve Palsy Associated with a Chronic Type I Monteggia Fracture-Dislocation in a Child: A Case Report and Review of the Literature

Ruchelsman

Pasqualetto

Price

et al. 2008

Hand (New York, N,Y.)

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“…Ulnar osteotomy is the key procedure in achieving and maintaining reduction as it addresses the primary deformity in the ulna [28] . Decreased length of the ulna and the angulation of the ulna in the direction opposite to the dislocation of the radial head are the most important findings leading to persistence of RHD [29] .…”

Section: Ulnar Osteotomymentioning

confidence: 99%

“…Hirayama et al [31] recommended a lengthening ulnar osteotomy with overcorrection of the ulnar deformity. Inoue et al [28] compared the results of simple and over-correction osteotomy of the ulna and found that the results were significantly better with overcorrection osteotomy. This was because of inadequate correction of ulnar deformity in patients with simple osteotomy, resulting in residual subluxation.…”

Section: Ulnar Osteotomymentioning

confidence: 99%

Corrective Ulnar Osteotomy and Annular Ligament Reconstruction by Fascia Lata in Neglected Monteggia Fracture Dislocation in Children.

Hưng

Sang²,

Nam³

2017

International Journal of Orthopaedics

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a prospective study 13 patients with mean age of 7 years and 7 months, who presented with neglected Monteggia fracture dislocation, were studied. The time interval between injury and presentation mean 7.2 months and ranged from 2 months to 25 months. The patients were classified according to Bado. All children underwent open reduction of the radiocapitellar joint, Ulnar osteotomy with angulation distraction and annular ligament reconstruction by fascia lata. We used Kim's score the for evaluation of our results. RESULTS:The mean follow-up period was 40.8 months. One of them without ulnar osteotomies healed uneventfully. Ulnar angulation at osteotomy site (°) mean 21.3° (16-25°); Ulnar lengthening at osteotomy site (cm) mean 0.85 cm (0.5-1.8 cm); Improvement PrePotoperation: Flexion-Extention 20.3%; Pronation 5,1%; Supination 13.7%; Total 13.7%. Surgical results: Excellent in 9; Good in 3; Fair in 1. Complication with nounion in 1 case, Cubitus valgus in 2 cases; Subluxation in 1 case. CONCLUSION:Late open reduction for chronically dislocated radial heads in children produces good to excellent results. Surgery for reduction should be attempted unless dysmorphism of the radial head restricts it. Open reduction with ulnar osteotomy with annular ligament reduction is the most commonly performed procedure and is expected to result in reduced pain and elbow deformity.statistically. ABSTRACT BACKGROUND: Neglected Monteggia fracture dislocation in children constitutes significant disability in respect to pain, stiffness, deformity, neurological compromise and restriction of activities of daily living. Many surgical technique have been described to manage neglected Monteggia fracture dislocation and common technique is the ulnar osteotomy for restoration of the ulnar length and reduction of the radial head with annular ligament reconstruction for restoration of the elbow biomechanics for this difficult problem.

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“…Furthermore, in subadult injuries, all of the other types are considered infrequent (Peiro et al, 1977;Wang et al, 1996;Inoue and Shionoya, 1998).…”

Section: Examination Of the Fracturementioning

confidence: 99%

Type I Monteggia fracture-dislocation in a monk from a 17th-18th century necropolis of Valladolid (Spain)

López

Caro

Pardiñas

2011

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This paper reports the study of the osseous remains of an adult male (30-35 years) from a Spanish urban necropolis dating from the pre-industrial age (17th-18th centuries). We have diagnosed the presence of a severe unreduced forearm fracture, which has been classified as a Type I Monteggia fracture in the left arm. Injury occurred by a complete and poorly resolved ulnar fracture in its upper third. As result of this ulna fracture a radial head dislocation also occurred, creating a new articular surface on the humerus. The ulna also underwent two different types of angulation. The purpose of this study is to evaluate the anatomical changes of the elbow joint bones after a Monteggia fracture, assessing the completeness of functionality on the arm of this man. After the fracture, this individual lived the rest of his life with a permanent dislocation of his radius; therefore, loss of the forearm rotation, cubitus valgus, elbow instability and pain were all present. Movement was limited to an intermediate position or semipronative. A detailed description of the pathology is also accompanied by a discussion of the historical-cultural context in which this man lived and the common diseases of the population to which he belonged.

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Corrective ulnar osteotomy for malunited anterior Monteggia lesions in children: 12 patients followed for 1-12 years

Cited by 74 publications

References 14 publications

Persistent Posterior Interosseous Nerve Palsy Associated with a Chronic Type I Monteggia Fracture-Dislocation in a Child: A Case Report and Review of the Literature

Persistent Posterior Interosseous Nerve Palsy Associated with a Chronic Type I Monteggia Fracture-Dislocation in a Child: A Case Report and Review of the Literature

Corrective Ulnar Osteotomy and Annular Ligament Reconstruction by Fascia Lata in Neglected Monteggia Fracture Dislocation in Children.

Type I Monteggia fracture-dislocation in a monk from a 17th-18th century necropolis of Valladolid (Spain)

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