Two-Year Outcome of Synthetic Annular Ligament Reconstruction in the Elbow: A Case Report

Abstract

Monteggia fracture is commonly treated with open anatomical reduction and fixation of the ulna fracture. The radial head will be automatically reduced once anatomical fixation of the ulna is achieved. However, it is occasionally associated with an irreducible radial head dislocation requiring an open reduction and reconstruction of the torn annular ligament. We describe a case of traumatic Monteggia fracture which underwent initial plating, however post-operative radiograph denoted an irreducible radial head secondary to a ruptured annular ligament. We reconstructed the annular ligament with a synthetic graft sling around the radial neck with an anchor suture. The radial head was stable in all directions after annular ligament reconstruction. A two-year follow-up shows full range of motion of the elbow joint with osteolysis of the radial head, no other operative morbidity was observed.

Long-Term Follow-Up of Synthetic Ligament (Orthotape) Usage in Reconstructive Surgery of the Hand

“…14e17 We used the Orthotape for the reconstruction of the torn annular ligament around the radial neck in a Monteggia fracture with an excellent outcome. 18 Focusing on our usage of the Orthotape in the hand, 4 of our 9 patients retained it over a period of 89e91 months (7.5 years), and 1 patient retained it at 60 months (5 years). Of these 5 patients, 2 had received a free flap which covered the Orthotape; however, the extrusion rate of 22.2% was concerning.…”

“… 14 , 15 , 16 , 17 We used the Orthotape for the reconstruction of the torn annular ligament around the radial neck in a Monteggia fracture with an excellent outcome. 18 …”