Open Reduction and Annular Ligament Reconstruction With Fascia of the Forearm in Chronic Monteggia Lesions in Children

Hui, James; Sulaiman, Abdul Razak; Lee, Haw-Chou; Lam, K.S.; Lee, Eng-Hin

doi:10.1097/01.bpo.0000158812.37225.b3

Cited by 74 publications

(94 citation statements)

References 23 publications

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“…Procedures include ulnar and radial osteotomies, open or closed reduction of the radial head, repair or reconstruction of the annular ligament, temporary fixation of the radial head with a transarticular wire, or some combination of these techniques [1][2][3][4][5][6][7][8][9][10][11][12][13]. In addition, the outcome of the surgical treatment of chronic radial head dislocation is uncertain, with reports of subluxation and re-dislocation, as well as complications including stiffness, elbow instability, nonunion of the osteotomies, avascular necrosis of the radial head, nerve injury, and infection [4,6,11,[14][15][16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

Surgical treatment of missed Monteggia lesions in children

Lädermann

Ceroni

Lefèvre

et al. 2007

Journal of Children's Orthopaedics

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Purpose The treatment of an unrecognized Monteggia lesion continues to pose a therapeutic challenge, as evidenced by the variety of surgical techniques described. Moreover, there are high complication and redislocation rates following surgery. This report concerns a surgical technique to reduce a chronic dislocation of the radial head utilizing an ulnar osteotomy and internal fixation. Methods Six consecutive cases of missed Monteggia lesions were treated in our institution between August 2001 and September 2003. Patient mean age was 6.5 (range 4-8) years, and the mean interval between injury and surgical procedure was 17 (range 1-49) months. Surgery consisted of an ulnar osteotomy with angulation and lengthening, bone grafting at the osteotomy site, and internal fixation. Open reduction of the radial head, repair or reconstruction of the annular ligament or temporary fixation of the radial head with a transarticular wire was not undertaken. Cast immobilization with the forearm in neutral rotation was maintained for 2 weeks. Results There was one case of nonunion. At an average follow-up of 3 (range 1.5-4.4) years, all patients had regained painless function of the forearm, good range of elbow and forearm motion, and maintenance of the radial head reduction. Conclusions Both angulation and elongation of the ulna are required to allow for reduction of the radial head. We do not see any indication for procedures directed at the radio-capitellar joint.

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Section: Introductionmentioning

confidence: 99%

Surgical treatment of missed Monteggia lesions in children

Lädermann

Ceroni

Lefèvre

et al. 2007

Journal of Children's Orthopaedics

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“…To our knowledge, this is the longest reported follow-up of a series of this kind [1,2,[5][6][7][8][9][10][11][12][13][14][25][26][27][28]. Only two other studies exist with a follow-up of more than 6 years [1,2].…”

Section: Discussionmentioning

confidence: 88%

Long-term outcome after ulnar osteotomy for missed Monteggia fracture dislocation in children

Rahbek

Deutch

Kold

et al. 2011

Journal of Children's Orthopaedics

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Case reports of similar patients treated conservatively demonstrate high morbidity, and, therefore, open reduction and ulnar osteotomy seemed justified. However, this study underlines the importance of minimizing the delay between injury and ulnar osteotomy. If surgery is performed within 40 months after injury, good to fair long-term radiographic results can be obtained. Open reduction and ulnar osteotomy were performed because patients treated conservatively demonstrate high morbidity.

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“…La secuela más frecuente tras la reducción de la cabeza del radio y la reconstrucción de las luxaciones crónicas en los niños es una pérdida de pronación. 14,15 También existe una importante controversia en cuanto al intervalo de tiempo que puede pasar entre la lesión inicial y el tratamiento para obtener buenos resultados con la cirugía. Los resultados dependerán de la edad del paciente y el tiempo transcurrido.…”

Section: S14unclassified

Lesión de Monteggia equivalente de presentación tardía en una niña de 6 años A propósito de un caso

Almero

Rey

Rodríguez³

et al. 2016

Rev Asoc Arg Ortop Traumatol (Supl)

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ResumenLas lesiones de Monteggia en los niños pueden pasar desapercibidas con facilidad, sobre todo, las variantes equivalentes. Es importante su diagnóstico y tratamiento precoces para evitar una cronificación de la lesión y, por lo tanto, una secuela funcional y cosmética, cuyo tratamiento es controvertido y puede conllevar graves complicaciones. Se presenta un caso poco frecuente de lesión de Monteggia equivalente en una niña de 6 años, que consiste en una deformidad plástica del cúbito proximal con un desplazamiento posterolateral de la cabeza del radio. Se trató al mes de la lesión mediante una reducción cerrada de la cabeza del radio, asociada a una osteotomía dorsal en cuña de cierre y extensora de unos 2 mm del cúbito proximal; se obtuvo un buen resultado.Palabras clave: Fractura de Monteggia; osteotomía; niño. Nivel de Evidencia: IV Late equivalent Monteggia injury in a 6-year-old girl: a case report AbstractMonteggia injuries in children can be missed easily, especially the equivalent variants. Early diagnosis and treatment are important to prevent chronicity of the injury, because treatment is controversial and it can cause serious complications. A rare case of Monteggia equivalent lesion in a 6-year-old girl is presented. It consists of a plastic deformity of the proximal ulna with posterolateral displacement of radio head. Patient was successfully treated with a closed reduction of radial head and a dorsal closing-wedge osteotomy (2 mm wedge) of the proximal ulna, one month after injury, with good results. IntroducciónLa fractura-luxación de Monteggia (luxación de la cabeza radial asociada a fractura proximal del cúbito) en niños es poco frecuente. Representa el 0,4% de todas las fracturas de antebrazo en pediatría 1 y, a menudo, pasa desapercibida en el momento de la lesión. En los niños, se puede producir también una variante especial, denominada variante de Monteggia equivalente, que consiste en una luxación o subluxación de la cabeza radial aislada o http://dx

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Open Reduction and Annular Ligament Reconstruction With Fascia of the Forearm in Chronic Monteggia Lesions in Children

Cited by 74 publications

References 23 publications

Surgical treatment of missed Monteggia lesions in children

Surgical treatment of missed Monteggia lesions in children

Long-term outcome after ulnar osteotomy for missed Monteggia fracture dislocation in children

Lesión de Monteggia equivalente de presentación tardía en una niña de 6 años A propósito de un caso

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