Chronic Radial Head Dislocation in Children, Part 2: Results of Open Treatment and Factors Affecting Final Outcome

Kim, Hui Taek; Park, Byung Guk; Suh, Jeung Tak; Yoo, Chong Il

doi:10.1097/01241398-200209000-00005

Cited by 78 publications

(86 citation statements)

References 15 publications

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“…We agree author's opinion that " ulnar osteotomy is the key for radial head reduction" [20] . The treatment we propose has been previously described and is based upon the hypothesis that the primary problem is malunion of the ulna preventing reduction of the radial head.…”

Section: Ulnar Osteotomysupporting

confidence: 50%

“…At the final follow-up, no patient had any sign of instability. Based on Kim's scores [20] there were nine patients with excellent and three patients with good, and one patients with fair results at the final follow up. (Table 2)…”

Section: Clinical Resultsmentioning

confidence: 99%

“…Loss of pronation was the most commonly observed effect of late reconstruction on range of motion. In the series of Kim et al [20] , it was observed in 11 out of 15 patients. There were two patients with subluxation of radial head in this study.…”

Section: Complicationsmentioning

confidence: 98%

“…Overall, surgery was associated with improved range of motion in the majority of the studies [30,42] . ALR has been found to be associated with poorer range of movement at follow-up [3,10,20] . Considerable loss of range of motion was observed at followup in both flexion-extension and supination-pronation planes.…”

Section: Complicationsmentioning

confidence: 99%

“…If the patient could not accomplish these tasks, a zero was given for each task he or she failed to perform without difficulty. Total elbow performance score was graded as excellent (90 or more points), good (89-75 points); fair (74-60 points); or poor (< 60 points) [20] .…”

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: Ulnar Osteotomysupporting

confidence: 50%

Section: Clinical Resultsmentioning

confidence: 99%

Section: Complicationsmentioning

confidence: 98%