Long-Term Clinical and Radiographic Outcomes After Open Reduction for Missed Monteggia Fracture-Dislocations in Children

Nakamura, Kōichi; Hirachi, Kazuhiko; Uchiyama, Shigeharu; Takahara, Masatoshi; Minami, Akio; Imaeda, Toshihiko; Kato, Hiroyuki

doi:10.2106/jbjs.h.00644

Cited by 136 publications

(175 citation statements)

References 41 publications

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“…Bhaskar [3] used bone graft for gaps more than 10mm. The use of a bone graft was mentioned in five studies in this review [34] . Bor et al [44] presented the results for patients in whom Illizarov's frame was used for correction.…”

Section: Bone Grafting Of Osteotomy Sitementioning

confidence: 95%

“…The mean arc of forearm rotation was also higher in the group treated with overcorrection osteotomy. Overcorrection of ulnar osteotomy has also been recommended by other authors [22,32,33,34] and may also help by eliminating the mechanical block to radial rotation from callus or fibrous tissue.…”

Section: Ulnar Osteotomymentioning

confidence: 99%

“…Controversy exists regarding reconstruction of the annular ligament. Nakamura et al [34] , and DavidWest et al [35] , advocate it in all cases while others like Devnani [2] , and Bhojraj et al [36] disregard it completely. Others like Bhaskar et al [3] , prefer an intra-operative decision based on the stability of reduction.…”

Section: Annular Ligament Recontructionmentioning

confidence: 99%

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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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Section: Bone Grafting Of Osteotomy Sitementioning

confidence: 95%

Section: Ulnar Osteotomymentioning

confidence: 99%

Section: Annular Ligament Recontructionmentioning

confidence: 99%

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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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“…However, treatment for chronic radial head dislocation is still controversial. To achieve open reduction of the radial head, ligament reconstruction [9,18,29,32], ulnar osteotomy [6,10], and a combination of both techniques [4,5,7,24,31,34,37] have been proposed. However, the radial Each author certifies that he or she, or a member of his or her immediate family, has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.…”

Section: Introductionmentioning

confidence: 99%

“…head sometimes remains subluxated or redislocated, even after these procedures [4,6,7,18,24,29,31,37]. Nonsurgical treatment leaving the radial head dislocated also has been advocated [11,12].…”

Section: Introductionmentioning

confidence: 99%

In Vivo Three-dimensional Motion Analysis of Chronic Radial Head Dislocations

Miyake

Moritomo

Kataoka

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background Forearm kinematics and interosseous membrane function in chronic radial head dislocations sustained in childhood are unknown. Several procedures have been performed to reduce the radial head on the basis of static preoperative assessment in only one forearm position, but clinical results are not always favorable. Questions/purposes We investigated the in vivo threedimensional (3D) kinematics and length changes of interosseous membrane ligaments during forearm rotation in chronic radial head dislocations using 3D CT registration techniques. Methods We examined 10 patients with chronic radial head dislocations (seven Type 1 and three Type 4 Monteggia lesions). To quantify kinematics, the axis of rotation (AOR) and radial head motion were investigated using computer bone models constructed from CT data placing the forearm in three positions. We also created six interosseous membrane ligaments and calculated their 3D lengths during forearm rotation.

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Monteggia Fracture Dislocations

Little

Draeger

2015

The Pediatric Upper Extremity

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Long-Term Clinical and Radiographic Outcomes After Open Reduction for Missed Monteggia Fracture-Dislocations in Children

Abstract: If open reduction for the treatment of a missed Monteggia fracture is performed when the patient is less than twelve years of age or within three years after the injury, good long-term clinical and radiographic outcomes can be expected.

Cited by 136 publications

References 41 publications

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

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

In Vivo Three-dimensional Motion Analysis of Chronic Radial Head Dislocations

Monteggia Fracture Dislocations

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