Operative treatment of chronic Monteggia lesion in younger children: A report of three cases

Koslowsky, Thomas C.; Mader, Konrad; Wulke, Andreas P.; Gausepohl, T.; Pennig, D.

doi:10.1016/j.jse.2004.12.002

Cited by 26 publications

(20 citation statements)

References 10 publications

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“…An unreduced dislocation of the radial head for more than 4 weeks is considered chronic [1], but its treatment in children is still controversial. If in the past, a conservative approach was advocated, more recently, several authors have shown that the natural history of an untreated dislocation is not benign.…”

Section: Introductionmentioning

confidence: 99%

Outcomes after surgical treatment of missed Monteggia fractures in children

et al. 2015

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Section: Introductionmentioning

confidence: 99%

Outcomes after surgical treatment of missed Monteggia fractures in children

et al. 2015

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“…In complex forearm corrections, and here in chronic Monteggia pathology patients, an individualized treatment plan depending onthe deformity, the age ofthe patient, and the status of the radial head and the PRU joint can either lead to a near anatomic reconstruction with good functional result or, in cases of longstanding deformity and established arthrosis, salvage procedures with good pain reduc-tion and functional improvement. Here the complication rate (in the authors' consecutive series) is >10%, comprising nerve injury (under 2%), residual deformity (around 6%), pin-site related infection (3%), reoperation for postoperative ulnar plus deformity, hardware removal, and soft tissue revision [1,3,12,13,21]. All complex corrections, e.g., fixator-based techniques, are prone Fig.…”

Section: Armamentarium and Resultsmentioning

confidence: 99%

“…Nonunion of the radial or ulnar condyle leads to severe arthrosis of the affected elbow joint, resulting in pain, loss of motion, and handicap in daily life and professional activities [8]. Chronic missed Monteggia deformity inevitably results in loss of flexion, forearm rotation, and arthritic deformity of the radiocapitellar joint [9][10][11][12][13][14]. In all cases, clinical history may reveal pain, stiffness, loss of motion, loss of strength, disability, and visible cosmetic changes.…”

Section: Examining the Patient Analyzing The Deformity And Informedmentioning

confidence: 99%

“…In the early phase (unrelated to the patient's age and without manifest deformity or arthrosis), the authors advise a variety of corrective procedures, all aiming for restitutio at integrum: percutaneous osteotomy and correction of the ulna using a Minifixator (Orthofix ® ) [13] with/ without open reduction of the radial head in the young child (<11 years of age); correction of the ulna with external fixator/plate with/without open reduction of the radial head (. Fig.…”

Section: Correcting Chronic Radial Head Dislocation (Missed Monteggiamentioning

confidence: 99%

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Korrekturosteotomie des distalen Humerus und Unterarms – eine praktische Übersicht

et al. 2019

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Complex deformities of the distal humerus and forearm of either posttraumatic or hereditary origin have a significant negative impact on the functional integrity of the affected limb. They lead to pain, instability in both the elbow and the proximal/distal radioulnar joint, and profound motion deficit. Corrective procedures and more advanced surgical interventions for the main index procedures at the proximal forearm are extremely challenging for the treating upper extremity specialist due to the complex pathoanatomy in this region. This practical review focuses on the main aspects of correcting deformities of the distal humerus (malunion and non-union), the proximal forearm (differential therapy of chronic radial dislocation in children and adolescents), and the restoration of forearm rotation using rapid prototyping templates and computerized planning as the evolving standard technique in this region. In addition to the technical aspects, focus is put on planning (conventional vs. modern computerized three-dimensional (3D) planning), on different osteotomy techniques, and the surgical armamentarium that the specialist center should have available. Finally, some light is shed on the long-term outcome that can be expected and possible complications that can occur when performing these complex corrective procedures.

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“…However prolonged immobilisation in a cast can cause contracture and possibly delayed union or even non-union [21] . Koslowsky et al have described an external fixator as fixation, a technique that provides the ability to do a percutaneous osteotomy and perform the correction through a three-dimensional correction of the ulnar axis [22] . In the series described in this study rigid fixation of the osteotomy site was done using a plate to prevent secondary displacement of the osteotomy.…”

Section: Discussionmentioning

confidence: 99%

Open reduction with ulnar osteotomy for chronic post-traumatic radial head dislocation in children

Agarwal¹,

Santra²

2017

Int. J. Orthop. Sci.

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Purpose: A number of surgical techniques with variable results and complications have been described for the treatment of chronic post-traumatic radial head dislocations or the missed Monteggia lesions. This study aims to evaluate open reduction of radial head with ulnar corrective osteotomy with rigid fixation with plate, without annular ligament reconstruction or repair. Methods: 11 patients were treated between 2011 and 2016, 7 were male while 4 were female, average age being 7.8 years (range 6-11.5 years). Right side was involved in 8/11. The average interval between injury and surgery was 4 months (range 2 to 11 months). Patients were followed up for mean period of 13 months (7-21 months), assessed clinically for elbow function, stability, pain, deformity and radiologically for reduction, periarticular ossifications, signs of malformation of the radial head or osteoarthritic changes. Results: All patient regained painless function of the elbow, adequate range of elbow and forearm motion with maintenance of the radial head reduction. Conclusion: Ulnar osteotomy with angulation and lengthening, provides adequate aid in reduction of radial head, without requiring additional annular ligament procedures.

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Operative treatment of chronic Monteggia lesion in younger children: A report of three cases

Cited by 26 publications

References 10 publications

Outcomes after surgical treatment of missed Monteggia fractures in children

Outcomes after surgical treatment of missed Monteggia fractures in children

Korrekturosteotomie des distalen Humerus und Unterarms – eine praktische Übersicht

Open reduction with ulnar osteotomy for chronic post-traumatic radial head dislocation in children

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