Long-term outcome after ulnar osteotomy for missed Monteggia fracture dislocation in children

Rahbek, Ole; Deutch, Søren R.; Kold, Søren; Søjbjerg, Jens Ole; Möller‐Madsen, Bjarne

doi:10.1007/s11832-011-0372-0

Cited by 51 publications

(65 citation statements)

References 33 publications

(112 reference statements)

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“…The longest duration of time between injury and surgical reduction was in the range of 7-10 years [12,15,18,20,29]. The longest duration of time between injury and surgical reduction was in the range of 7-10 years [12,15,18,20,29].…”

Section: Resultsmentioning

confidence: 99%

“…The mean age of the patients varied between 6 and 8.5 in most studies [9][10][11][12][13]15,17,20,22,[24][25][26][27][28]30,31,[33][34][35][36]. Pain, deformity, and reduced range of motion were the most common complaints, which showed improvement after the surgery [9,11,12,15,16,18,20,24,26,30,33]. Data on the direction of dislocation were available on 256 patients.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Neglected Monteggia fracture dislocations in children

Goyal

Arora

Banerjee

et al. 2015

Journal of Pediatric Orthopaedics B

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Monteggia fractures are uncommon and frequently missed injuries in children. This article aims to study, in a systematic manner, the surgical management and complications of treatment of chronic radial head dislocations. After screening of relevant abstracts, a total of 28 studies were included in the systematic review. A narrative synthesis of various treatment modalities has been discussed. This article concludes that open reduction should be attempted unless dysmorphism of the radial head restricts it. Open reduction with ulnar osteotomy with or without annular ligament reconstruction is the most commonly performed procedure and is expected to result in reduced pain and elbow deformity.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Neglected Monteggia fracture dislocations in children

Goyal

Arora

Banerjee

et al. 2015

Journal of Pediatric Orthopaedics B

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“…Open reduction of radiocapitellar joint as a first surgical approach may be an inappropriate solution for missed Monteggia fracture. However, in some previous studies, ulnar osteotomy for the treatment of missed Monteggia fracture has been performed at proximal area not original fracture site of the ulnar, which helped maintain the integrity of the interosseous membrane 123233. Although ulnar osteotomy is not a difficult procedure, there are several complications related to ulnar osteotomy, including delayed union, nonunion, fixation failure, and negative cosmetic problems 9143435.…”

Section: Discussionmentioning

confidence: 99%

Impact of Open Reduction on Surgical Strategies for Missed Monteggia Fracture in Children

Park

et al. 2017

Yonsei Med J

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PurposeThe aims of this study were to review our cases of missed Monteggia fracture treated by open reduction of the radial head with or without ulnar osteotomy and to investigate the indications for open reduction alone in surgical treatment of missed Monteggia fracture.Materials and MethodsWe retrospectively reviewed 22 patients who presented with missed Monteggia fracture. The patients' mean age at the time of surgery was 7.6 years. The mean interval from injury to surgery was 16.1 months. The surgical procedure consisted of open reduction of the radiocapitellar joint followed by ulnar osteotomy without reconstruction of the annular ligament. The mean period of follow-up was 3.8 years. Radiographic assessment was performed for the maximum ulnar bow (MUB) and the location of the MUB. Clinical results were evaluated with the Mayo Elbow Performance Index and Kim's scores.ResultsFive patients underwent open reduction alone, and 17 patients underwent open reduction and ulnar osteotomy. When the MUB was less than 4 mm and the location of the MUB was in the distal 40% of the ulna, we could achieve reduction of the radial head without ulnar osteotomy. The radial head was maintained in a completely reduced position in 21 patients and was dislocated in one patient at final follow-up.ConclusionOpen reduction alone can be an attractive surgical option in select patients with missed Monteggia fracture with minimal bowing of the distal ulna. However, ulnar osteotomy should be considered in patients with a definite ulnar deformity.

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“…[12] This is complicated in children by the rapid growth of their bones, making the tightness of annular ligament reconstruction hard to control. Reconstruction that is too loose may easily result in dislocation, whereas too tight reconstruction may affect the rotation of the forearm.…”

Section: Discussionmentioning

confidence: 99%

Type III Monteggia fracture with posterior interosseous nerve injury in a child

Wang

Chen²,

Du³

2017

Medicine

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Rationale:Elbow injury in children by improper treatment or a delay of more than 3 weeks could lead to old unreduced Monteggia fracture, which are difficult to manage. Conservative or normal surgical methods usually fail.Patient concerns:Herein, we present a 6-year-old boy with sustaining injury approximately 1 month to his left elbow. Activity in his elbow was restricted, and his ability to extend his wrist and fingers was impaired.Diagnoses:Type III Monteggia elbow fracture-dislocation consisting of radial head dislocation and malunion of the ulna associated with posterior interosseous nerve palsy were confirmed, which requiring surgical treatment.Interventions:A closed reduction was performed with hyperplastic scar tissues erased and the radial head relocated.Outcomes:Follow-up 4 months later showed satisfactory recovery of function.Lessons:Forearm fractures in children may be misjudged, and that early anatomical reduction rather than conservative treatment may be required.

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Long-term outcome after ulnar osteotomy for missed Monteggia fracture dislocation in children

Cited by 51 publications

References 33 publications

Neglected Monteggia fracture dislocations in children

Neglected Monteggia fracture dislocations in children

Impact of Open Reduction on Surgical Strategies for Missed Monteggia Fracture in Children

Type III Monteggia fracture with posterior interosseous nerve injury in a child

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