Surgical Management of Complex Adult Monteggia Fractures

Xiao, Ryan; Chan, Jimmy J.; Cirino, Carl M.; Kim, Jaehon M.

doi:10.1016/j.jhsa.2021.07.023

Cited by 9 publications

(4 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The surgical treatment of Monteggia fracture primarily focuses on reconstructing the anatomic alignment of the ulna, and the radio-capitular joint is often reduced as an indirect effect. However, if the radial head remains subluxated, open reduction for the incarcerated ligament may be considered [11][12][13]. Moreover, in proximal ulna fracture-dislocation (also known as trans-olecranon fracture-dislocation), since the PRUJ is intact, the treatment strategy is aimed at restoration of the trochlear notch [14].…”

Section: Discussionmentioning

confidence: 99%

How proximal ulnar shaft fracture could easily result in radial head dislocation? A critical value analysis for proximal ulnar fracture in Monteggia fracture

Huang,

Chen,

Lin

2024

Preprint

View full text Add to dashboard Cite

Background Monteggia fracture is defined as a combination of proximal ulnar fracture with radial head dislocation. Radial head dislocation may be misdiagnosed under elbow X-ray, leading to further complications. This study aimed to analyze the fracture pattern between extra-articular Monteggia fracture and an isolated proximal ulnar fracture to determine the difference in terms of how close the fracture site is to the coronoid and what type of fracture pattern is more likely to result in radial head dislocation. Methods This is a single-center, retrospective study. In 2014/01-2022/06, adult patients with fractures in the proximal to midshaft ulna were collected. Nonacute trauma, revision surgeries, and intra-articular ulnar fractures were excluded. All patients received elbow X-rays in AP and lateral views, and forearm X-rays. The fracture pattern and injury mechanism were recorded. Results We included 51 patients in this study. The mean patient age was 38.5 ± 16.1 years. 70.1% were men (n = 36). Extra-articular Monteggia fractures were classified according to the Bado classification into type I (n = 5), type II (n = 7), type III (n = 8), and type IV (n = 0). 63% were traffic accidents (n = 32). 45% were oblique type ulnar fractures(n = 23). Monteggia fracture and proximal ulnar fracture presented with mean ulnar fragment lengths of 6.12 ± 2.32 cm and 9.00 ± 3.00 cm (p < 0.01). As per the ROC, a proximal ulnar fragment length of 7.325 cm had the highest value for the AUC (0.807). Angulations of Monteggia fracture and ulnar fracture were 24.02 ± 12.10° and 10.77 ± 8.10° (p < 0.01). However, there were no differences in the length of the fracture line between two groups. Conclusions Fractures of the proximal ulna within 7.325 cm from the coronoid are more likely to cause an extra-articular Monteggia fracture than a pure proximal ulnar fracture. Otherwise, a Montelggia fracture is prone to more severe angulation.

show abstract

Section: Discussionmentioning

confidence: 99%

How proximal ulnar shaft fracture could easily result in radial head dislocation? A critical value analysis for proximal ulnar fracture in Monteggia fracture

Huang,

Chen,

Lin

2024

Preprint

View full text Add to dashboard Cite

show abstract

“…Radial head fractures account for 17–19% of elbow trauma cases and 33% of elbow fractures [ 26 ]. The modified Mason classification is widely used and can provide a reference for the treatment of radial head fractures [ 27 ]. Surgical intervention might be more appropriate for modified Mason type II-IV fractures [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Relative Prevalence and Associated Factors of Complex Regional Pain Syndrome Type I in Patients with Radial Head Fractures Treated with Open Reduction and Internal Fixation: A Cross-Sectional Study

Jia

Ren

Shi

et al. 2022

Pain Research and Management

View full text Add to dashboard Cite

Objective. This cross-sectional study aimed to examine the incidence and associated factors of complex regional pain syndrome type I (CRPS I) in patients who underwent open reduction and internal fixation (ORIF) for radial head fractures. Methods. The study enrolled 601 radial head fracture patients treated with ORIF, 523 of which completed the 1-year follow-up. The incidence of CRPS I in those patients was assessed using the Budapest criteria. Patients were then divided into 2 groups: patients with CRPS I (n = 28) and patients without CRPS I (n = 495). The patients’ demographic and clinical data before the operation were prospectively collected by our team. Independent t-tests and χ2 tests were used as univariate analyses to compare the demographic and clinical data between the two groups. Meanwhile, multivariate regression analysis was conducted to identify the associated risk factors for CRPS I. Results. The incidence of CRPS I in patients with radial head fractures treated with ORIF was 5.5% during the first year following surgery. Significant differences were observed in age, gender, type of trauma, modified Mason Classification, and depressive personality disorders. The logistic regression analysis revealed that the female gender, modified Mason type III fractures, and depressive patients were significantly more likely to develop CRPS I ( p = 0.021 , 0.023, and 0.025, respectively). Conclusions. The incidence of CRPS I among radial head fracture patients undergoing ORIF was 5.5%. In addition, early detection of CRPS I and providing adequate intervention will likely result in greater benefits for those patients.

show abstract

“…In 1991, Jupiter then subdivided the most common Bado type II lesion, which is a posterior displacement of the radial head, into four subtypes based on the ulna fracture's location and the involvement of the coronoid process and/or radial head fracture. The Jupiter classification, by incorporating the coronoid and radial head, helped to anticipate ulnohumeral instability, surgical complexity, implant needs, and functional outcomes related to Bado Type II's [3]. Bado further described injuries that he judged as equivalent to each variant type [4].…”

Section: Introductionmentioning

confidence: 99%

Type I Monteggia Fracture with Associated Ipsilateral Capitellar and Humeral Diaphyseal Fractures in an Adult

McDonald,

Kannenberg,

Goodrum

et al. 2024

Osteology

View full text Add to dashboard Cite

Background: Monteggia fractures entail a proximal ulnar fracture with associated radial head dislocation. Primarily observed as a fracture in the pediatric population, there have been rare occurrences in adults. In rare instances, various associated fractures have been reported with Monteggia fractures. However, during our literature review, a type I Monteggia fracture had not been reported along with ipsilateral diaphyseal humerus and capitellar fractures. Here, we present a successful post-operative outcome for a unique fracture distribution and form of fixation that has yet to be reported in the literature.

show abstract

Surgical Management of Complex Adult Monteggia Fractures

Cited by 9 publications

References 46 publications

How proximal ulnar shaft fracture could easily result in radial head dislocation? A critical value analysis for proximal ulnar fracture in Monteggia fracture

How proximal ulnar shaft fracture could easily result in radial head dislocation? A critical value analysis for proximal ulnar fracture in Monteggia fracture

Relative Prevalence and Associated Factors of Complex Regional Pain Syndrome Type I in Patients with Radial Head Fractures Treated with Open Reduction and Internal Fixation: A Cross-Sectional Study

Type I Monteggia Fracture with Associated Ipsilateral Capitellar and Humeral Diaphyseal Fractures in an Adult

Contact Info

Product

Resources

About