Radial neck fracture or Monteggia equivalent lesion: delayed radial head subluxation in an adolescent and review of literature

Xu, Lujie; Ye, Wensong

doi:10.1186/s12891-020-03315-0

Cited by 5 publications

(3 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[ 8 ] In conservative treatment, close follow-up is essential, which we were also scrupulous about because the loss of reduction rate can be as high as 20%. [ 12 , 13 ]…”

Section: Discussionmentioning

confidence: 99%

Functional outcomes of pediatric true and equivalent Monteggia fractures – Review of the literature

Aslan

Gedik

Birsel

et al. 2023

Ulus Travma Acil Cerrahi Derg

View full text Add to dashboard Cite

BACKGROUND: This study aims to describe the functional outcome of true and equivalent Monteggia fracture-dislocations in the pediatric population. We also provided a review of the literature about the treatment options. METHODS: Five surgically and three conservatively treated patients were identified who were treated in 2009-2021. The study population consisted of six female and two male patients. The mean age at the time of treatment was 7. The mean follow-up time was 55 months (range, 12–128). The Mayo Elbow Performance Score and the Oxford Elbow Score were used for outcome evaluation. Range of motion and grip strengths were also evaluated. RESULTS: There were two Bado type 1 and six Monteggia equivalent injuries. Closed reduction and casting were utilized for the two Bado type 1 injuries as the initial treatment. However, one had a radial head re-dislocation and had to be treated operatively. This patient had a radial head re-dislocation after the surgery and was followed up conservatively. Three Monteggia equivalent injuries were treated with closed reduction and casting, with no complications. One patient had a radial head anterior dislocation with plastic deformation of the ulna, and this patient was managed with CORA-based corrective ulnar osteotomy. For Monteggia injuries, the main treatment objective is to restore the ulnar length. Bilateral computed tomography imaging with 3D reconstruction can be utilized in preoperative planning of Monteggia fracture-dislocations to customize the treatment. Close observation is essential to detect radial head subluxation, which needs early intervention before irreversible changes occur. CONCLUSION: The true/equivalent Monteggia fractures’ main treatment goal is to restore the ulnar length. Conservative treatment, with a close follow-up, is the first option if closed reduction can be achieved. If closed reduction is not possible, careful preoperative planning and early rehabilitation are key to success for management of Monteggia fractures.

show abstract

“…[ 8 ] In conservative treatment, close follow-up is essential, which we were also scrupulous about because the loss of reduction rate can be as high as 20%. [ 12 , 13 ]…”

Section: Discussionmentioning

confidence: 99%

Functional outcomes of pediatric true and equivalent Monteggia fractures – Review of the literature

Aslan

Gedik

Birsel

et al. 2023

Ulus Travma Acil Cerrahi Derg

View full text Add to dashboard Cite

show abstract

“…Intra-articular fractures are less common in skeletally immature children compared to skeletally mature adolescents (52 vs 7 per cent) and may be missed on radiographic imaging[ 38 ]. Recent case series have reported rapid radiocapitellar degeneration and progressive radial head subluxation in pediatric patients with an intra-articular radial head fracture[ 39 , 40 ]. This type of fracture should not be underestimated and should, in contrast to extra-articular fractures, be treated more aggressively.…”

Section: Treatment and Outcomementioning

confidence: 99%

Diagnosis, treatment and complications of radial head and neck fractures in the pediatric patient

Macken

Eygendaal

Bergen

2022

WJO

View full text Add to dashboard Cite

Radial head and neck fractures represent up to 14% of all pediatric elbow fractures and can be a difficult challenge in the pediatric patient. In up to 39% of proximal radius fractures, there is a concomitant fracture, which can easily be overlooked on the initial standard radiographs. The treatment options for proximal radius fractures in children range from non-surgical treatment, such as immobilization alone and closed reduction followed by immobilization, to more invasive options, including closed reduction with percutaneous pinning and open reduction with internal fixation. The choice of treatment depends on the degree of angulation and displacement of the fracture and the age of the patient; an angulation of less than 30 degrees and translation of less than 50% is generally accepted, whereas a higher degree of displacement is considered an indication for surgical intervention. Fractures with limited displacement and non-surgical treatment generally result in superior outcomes in terms of patient-reported outcome measures, range of motion and complications compared to severely displaced fractures requiring surgical intervention. With proper management, good to excellent results are achieved in most cases, and long-term sequelae are rare. However, severe complications do occur, including radio-ulnar synostosis, osteonecrosis, rotational impairment, and premature physeal closure with a malformation of the radial head as a result, especially after more invasive procedures. Adequate follow-up is therefore warranted.

show abstract

“…The discussion has never stopped over 'the equivalent' as to its presentation, injury combination, mechanism, diagnosis, and management in the past several decades when a few sporadic case reports demonstrated some of the unclassifiable 'equivalent'. [8][9][10][11][12][13][14][15][16][17][18][19][20] A most recent contribution towards the definition has been made by Čepelík et al 21 and his group in their study of 111 cases. They defined it as an ulnar fracture at any level combined with 'displaced' (with undisplaced or minimal displaced ones were not included) proximal radial fracture, which embraced Olney criteria and was consistent with Bado Ia-Ic.…”

Section: Definitionmentioning

confidence: 99%

Monteggia equivalent lesion in children: a narrative review

et al. 2021

World Jnl Ped Surgery

Self Cite

View full text Add to dashboard Cite

BackgroundMonteggia equivalent lesion represents a group of injury or combined injury patterns that resemble the Monteggia lesion in its presentations and mechanisms. Unlike Monteggia lesions, the equivalent ones, which share vague definitions and mostly occur as sporadic single case reports in the literature, have not been thoroughly reviewed since Bado first proposed the term, especially in the pediatric population. The objective of this review was to elucidate the definition by elaborating on its clinical styles and thus analyzing the mechanism, diagnosis, and management through related literature.Data sourcesBased on the terms of ‘Monteggia equivalent’, ‘radial neck fracture’ and ‘pediatric’, all of the related literature was searched on the PubMed and Google Scholar search engine.ResultsThe advance of the definitions for pediatric Monteggia equivalent lesion (PMEL) was reviewed. The functional roles of the ulnar and the related mechanism theories in this injury were analyzed. The status of the radiocapitellar joint in this injury was emphasized. According to the previous statements, a new classification model was proposed and proper diagnosis and treatment approaches were suggested.ConclusionsPMEL should be defined as an ulnar fracture at any level combined with a proximal radial fracture. According to the status of the radiocapitellar joint, it could be divided into three groups. The occult ulnar bowing and delayed radial head dislocation should be a serious concern of orthopedists. Surgical need is usually warranted. Maintaining the ulnar length and securing the radiocapitellar joint are highly recommended.

show abstract

Radial neck fracture or Monteggia equivalent lesion: delayed radial head subluxation in an adolescent and review of literature

Cited by 5 publications

References 29 publications

Functional outcomes of pediatric true and equivalent Monteggia fractures – Review of the literature

Functional outcomes of pediatric true and equivalent Monteggia fractures – Review of the literature

Diagnosis, treatment and complications of radial head and neck fractures in the pediatric patient

Monteggia equivalent lesion in children: a narrative review

Contact Info

Product

Resources

About