Monteggia and Equivalent Lesions in Childhood

Olney, Brad W.; Menelaus, Malcolm B.

doi:10.1097/01241398-198903000-00021

Cited by 115 publications

(47 citation statements)

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“…A varus deformity was found to be most common in other series. 4,18 Shortening and malrotation may also occur. No coronal deformity was seen in any of our patients and malrotation is difficult to assess by clinical and radiological methods.…”

Section: Discussionmentioning

confidence: 99%

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Open reduction, ulnar osteotomy and external fixation for chronic anterior dislocation of the head of the radius

Hasler

Laer

Hell

2005

The Journal of Bone and Joint Surgery. British volume

105

103

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We reviewed 15 patients, nine girls and six boys, with chronic anterior dislocation of the radial head which was treated by ulnar osteotomy, external fixation and open reconstruction of the elbow joint but without repair of the annular ligament. Their mean age was 9.5 years (5 to 15) and the mean interval between the injury and reconstruction was 22 months (2 months to 7 years).All radial heads remained reduced at a mean follow-up of 20 months (6 months to 5 years). Normal ranges of movement for flexion, extension, pronation and supination were unchanged in 96.1% (49/51) and worse in 3.9% (2/51). Limited ranges of movement were improved in 77.8% (7/9), unchanged in 11% (1/9) and further decreased in 11% (1/9).There were two superficial pin-track infections and two cases of delayed union but with no serious complications. Reconstruction of the radiocapitellar joint is easier using external fixation since accurate correction of the ulna can be determined empirically and active functional exercises started immediately. Only patients with a radial head of normal shape were selected for treatment by this method.The outcome of surgical reconstruction of long-standing dislocation of the radial head is uncertain. Further subluxation and dislocation may occur in more than 20% of patients.

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Section: Discussionmentioning

confidence: 99%

“…Most Monteggia fractures occur between five and seven years of age when there is a high potential for secondary changes in radial morphology because of the amount of growth remaining. 18 There is usually some proximal migration of the radial head. This may be secondary to relative ulnar shortening due to a post-traumatic flexion deformity.…”

Section: Discussionmentioning

confidence: 99%

Open reduction, ulnar osteotomy and external fixation for chronic anterior dislocation of the head of the radius

Hasler

Laer

Hell

2005

The Journal of Bone and Joint Surgery. British volume

105

103

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“…Bado coined the term "Monteggia's injury," and carried out a thorough classification of this injury in terms of four typologies (Table 1, Figure 1) based on the direction of the dislocation of the radial head and the angulation of the fracture of the ulna (Bado, 1967). In recent decades, many authors have contributed to understanding the complexity of this injury, both in adults (Natalio Firpo and Roque Valls, 1969;Rossiter, 1970;Bryan, 1971;Eathiraju et al, 2007;Konrad et al, 2007;Cheung and Yao, 2009;Nakamura et al, 2009) and subadults (Fowles et al, 1983;Letts et al, 1985;Olney and Menelaus, 1989). It is important to note that these types of fractures differ between both age groups in terms of the mechanism and patterns of the injury Table 1.…”

Section: The Monteggia Fracture-dislocationmentioning

confidence: 99%

Type I Monteggia fracture-dislocation in a monk from a 17th-18th century necropolis of Valladolid (Spain)

López

Caro

Pardiñas

2011

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This paper reports the study of the osseous remains of an adult male (30-35 years) from a Spanish urban necropolis dating from the pre-industrial age (17th-18th centuries). We have diagnosed the presence of a severe unreduced forearm fracture, which has been classified as a Type I Monteggia fracture in the left arm. Injury occurred by a complete and poorly resolved ulnar fracture in its upper third. As result of this ulna fracture a radial head dislocation also occurred, creating a new articular surface on the humerus. The ulna also underwent two different types of angulation. The purpose of this study is to evaluate the anatomical changes of the elbow joint bones after a Monteggia fracture, assessing the completeness of functionality on the arm of this man. After the fracture, this individual lived the rest of his life with a permanent dislocation of his radius; therefore, loss of the forearm rotation, cubitus valgus, elbow instability and pain were all present. Movement was limited to an intermediate position or semipronative. A detailed description of the pathology is also accompanied by a discussion of the historical-cultural context in which this man lived and the common diseases of the population to which he belonged.

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“…Classification of these injuries by the direction of displacement of the radial head is useful to establish the appropriate method of reduction and the position of immobilisation (Bado 1967), but it is the character of the ulnar fracture which determines which injuries are unstable and therefore require operative fixation (Fowles et al 1983;Olney and Menelaus 1989).…”

mentioning

confidence: 99%

“…In the treatment of Monteggia-type fracture-dislocations, emphasis has been placed on the stable, anatomical reduction of the ulnar fracture (Boyd and Boals 1969;Olney and Menelaus 1989;Jupiter et al 1991), but, even in children, this may require operative fixation (Fowles, Sliman and Kassab 1983;Olney and Menelaus 1989). Classification of these injuries by the direction of displacement of the radial head is useful to establish the appropriate method of reduction and the position of immobilisation (Bado 1967), but it is the character of the ulnar fracture which determines which injuries are unstable and therefore require operative fixation (Fowles et al 1983;Olney and Menelaus 1989).…”

mentioning

confidence: 99%

Operative Fixation of Monteggia Fractures in Children

Ring

Waters

1996

The Journal of Bone and Joint Surgery. British volume

115

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W e reviewed 36 consecutive patients withMonteggia fracture-dislocations of the forearm; 28 had been treated within 24 hours and 8 had been referred a week or more after the initial injury with persisting or recurrent dislocation of the proximal radio-ulnar joint after treatment elsewhere. We treated 15 of the 16 complete fractures and 3 of the 11 incomplete fractures of the ulna by operative fixation.All the early fractures and six of the eight late referrals had good or excellent results. The two poor results were in patients with malalignment and dislocation of the radial head persisting for at least two weeks before definitive treatment.A good outcome after a Monteggia injury in a child requires early diagnosis and prompt, stable, anatomical reduction of the ulnar fracture. In our experience, selective operative fixation of unstable fractures provides reliable reduction and causes few complications.

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Monteggia and Equivalent Lesions in Childhood

Cited by 115 publications

References 0 publications

Open reduction, ulnar osteotomy and external fixation for chronic anterior dislocation of the head of the radius

Open reduction, ulnar osteotomy and external fixation for chronic anterior dislocation of the head of the radius

Type I Monteggia fracture-dislocation in a monk from a 17th-18th century necropolis of Valladolid (Spain)

Operative Fixation of Monteggia Fractures in Children

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