Monteggia fracture-dislocations in children

Letts, Merv; Locht, R; Wiens, J

doi:10.1302/0301-620x.67b5.4055869

Cited by 173 publications

(82 citation statements)

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“…It is accepted that good results can be achieved after closed reduction and cast immobilisation in children (Pieró, Andres and Fernandes-Esteve 1977;Letts, Locht and Wiens 1985;Olney and Menelaus 1989), but satisfactory treatment in adults requires internal fixation of the ulnar fracture (Speed and Boyd 1940;Boyd and Boals 1969;Bruce et al 1974;Reckling 1982;Jupiter et al 1991). An important distinction between Monteggia lesions in children and adults is the character of the ulnar fracture.…”

Section: Discussionmentioning

confidence: 99%

“…An important distinction between Monteggia lesions in children and adults is the character of the ulnar fracture. Fractures of immature bone, including plastic deformation and buckle and greenstick fractures, are usually more stable, allowing maintenance of anatomical reduction in a cast (Wright 1963;Theodorou 1969;Letts et al 1985;Olney and Menelaus 1989). The complete, and often comminuted fractures seen in adults require plate and screw fixation of the dorsal (tension) surface of the ulna to provide a stable anatomical reduction (Boyd and Boals 1969;Jupiter et al 1991).…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

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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“…Freedman et al used a technique in which the annular ligament was not reconstructed but the radial notch was deepened to achieve stability [38] . Several resources have been used for the reconstruction of the annular ligament: grafts from the fascial strips of the forearm [9,39] , fascia lata [37,40] , tendon of palmaris longus [12] , triceps tendon [31,37] , and extensor aponeurosis [12] as well as nylon thread [39] . However, each of these tissues has its own drawbacks.…”

Section: Annular Ligament Recontructionmentioning

confidence: 99%

“…It divides four types true Monteggia lesions and some "equivalent lesions" based on the direction of ulna angulation and radial head displacement [4] . Letts et al proposed a pediatric classification, subdividing the Bado type 1 based on the ulnar fracture pattern (plastic deformation, greenstick, and complete) [9] . Monteggia fractures in the pediatric population can result in excellent outcomes if recognized early and treated promptly.…”

Section: Introductionmentioning

confidence: 99%

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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“…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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Monteggia fracture-dislocations in children

Cited by 173 publications

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Operative Fixation of Monteggia Fractures in Children

Operative Fixation of Monteggia Fractures in Children

Corrective Ulnar Osteotomy and Annular Ligament Reconstruction by Fascia Lata in Neglected Monteggia Fracture Dislocation in Children.

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

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