Surgical Reconstruction of Missed Monteggia Lesions in Children

Zheng, Evan T.; Waters, Peter M.; Vuillermin, Carley; Williams, Kathryn; Bae, Donald S.

doi:10.1097/bpo.0000000000001630

Cited by 15 publications

(7 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Il s´agit de 4 voies d´abord : la voie postéro-latérale, soit externe [ 25 ] ou interne [ 26 ], la voie externe de Kocher [ 27 ] et la voie antéro-externe de Henry. L´ostéosynthèse de l´ulna était assurée par plusieurs moyens chirurgicaux [ 28 ].…”

Section: Discussionunclassified

See 1 more Smart Citation

Fractures-luxations de Monteggia chez l´enfant: étude rétrospective de 40 cas dans le Département d´Orthopédie, Centre Hôpital Universitaire Habib Bourguiba de Sfax, Tunisie

Sahnoun¹,

Mabrouk²,

Aoui³

et al. 2022

Pan Afr Med J

View full text Add to dashboard Cite

Les fractures luxations de Monteggia représentent une entité rare en traumatologie infantile, elles représentent essentiellement un problème de délai de prise en charge et un réel problème pronostique. L'objectif de ce travail est de décrire les caractéristiques épidémiologiques de cette fracture, d´évaluer nos résultats fonctionnels et anatomiques. Nous rapportons une série de 40 cas de fracture Monteggia chez l´enfant colligés et traités au centre hospitalo-universitaire Habib Bourguiba de Sfax sur une période de 17 ans, allant de janvier 1998 au janvier 2015. Nous avons recensé les données épidémiologiques de notre population ainsi que les types des fractures luxations selon les classifications radiologiques Bado. Pour l´évaluation fonctionnelle, le choix du traitement était basé sur le type de fracture. Nous avons choisi les scores de l´équipe du P. Rigault et le score de Kim. L´âge moyen de notre population était d 8 ans. 20 cas des fractures étaient classés Bado I et 12 cas étaient Bado III. Le délai de prise en charge était moins de 24h dans 82% des cas. Le traitement chirurgical était réalisé dans 28 cas, et nos résultats fonctionnels ont été jugés bons dans 30 cas. Nos résultats étaient satisfaisants grâce à notre délai de prise en charge considéré précoce par rapport à ceux de la littérature.

show abstract

Section: Discussionunclassified

“…Dès la consolidation, les broches devraient être enlevés évitant toute migration des broches et tout conflit avec la peau qui est source d´infection [ 28 ]. Nos résultats globaux sont comparables à ceux publiés dans la majorité des séries.…”

Section: Discussionunclassified

Fractures-luxations de Monteggia chez l´enfant: étude rétrospective de 40 cas dans le Département d´Orthopédie, Centre Hôpital Universitaire Habib Bourguiba de Sfax, Tunisie

Sahnoun¹,

Mabrouk²,

Aoui³

et al. 2022

Pan Afr Med J

View full text Add to dashboard Cite

show abstract

“…Como terapêutica, na fase aguda, o tratamento de escolha se baseia na redução incruenta da luxação e da fratura sob sedação e imobilização por cerca de 4 semanas. Já nos casos crônicos, várias técnicas são descritas, com possibilidade desde a redução aberta e fixação da cabeça do rádio, com ou sem a reconstrução do ligamento anular; associado a osteotomia ulnar, na porção diafisária ou metafisária, promovendo sua flexão e consequente alongamento (1,9,10) . Goyal et al (1) em revisão sistemática aponta a osteotomia ulnar como o pivô central do tratamento com predileção para sua realização na região metafisária proximal, dado a maior capacidade de correção e potencial de consolidação.…”

Section: Discussionunclassified

Osteotomia da ulna para correção cirúrgica de fratura de Monteggia negligenciada em criança com deformidade plástica da ulna. Relato de caso / Ulna osteotomy for surgical correction of neglected Monteggia fracture in a child with ulna bowing. Case report

Garotti

Carrenho

Netto

2021

Arq Med Hosp Fac Cienc Med Santa Casa São Paulo

View full text Add to dashboard Cite

Introdução: A luxação da cabeça do rádio com deformidade plástica da ulna, quando combinadas, configuram uma condição rara, e frequentemente não diagnosticada na urgência. Objetivo: Relatar um caso de fratura de Monteggia negligenciada em criança com defomidade plástica da ulna, tratada cirurgicamente com redução e fixação da cabeça dorádio, sem reconstrução do ligamento anular, e osteotomia da ulna. Relato do Caso: Paciente de 6 anos de idade, sexo masculino, vítima de queda ao solo com a mão espalmada, deu entrada em Unidade de Pronto Atendimento com queixa de dor no cotovelo direito. Paciente foi submetido à exames de imagem radiográficos do cotovelo interpretados peloexaminador como sem alterações. Duas semanas após, o paciente retornou mantendo dor, e foram solicitados exames de radiografia do antebraço, que evidenciaram presença de deformidade plástica da ulna associada à luxação da cabeça do rádio. Como tratamento, optou-se pela redução aberta e fixação da cabeça do rádio com fios metálicos, associado aosteotomia de flexão da ulna fixada com fio de Kirschnner. Evoluiu no pós operatório com consolidação da osteotomia, manutenção da redução da cabeça do rádio, e recuperação do arco de movimento total do cotovelo e antebraço. Conclusão: Pacientes pediátricos que se apresentam com dor no cotovelo, em decorrência de queda com a mão espalmada, devem ser minuciosamente avaliados quanto à possibilidade de deformidade plástica da ulna associada à luxação da cabeça do rádio. A osteotomia na ulna com fixação da cabeça do rádio, sem reconstrução do ligamento anular, trouxe bom resultado no tratamento de fratura de Monteggia negligenciada em criança com defomidade plástica da ulna. Palavras chave: Fratura de Monteggia, Ulna/deformidades, Fraturas da ulna, Osteotomia, Trauma, Criança, Pediatria Abstract Introduction: Dislocation of the radial head with ulna bowing, when combined, constitutes a rare condition, and often missed diagnosed. Objective: Report a case of neglected Monteggia fracture in a child with ulna bowing, treated surgically with reduction and fixation of the radial head, without reconstruction of the annular ligament, and osteotomy of the ulna. Case Report: A 6-year-old male patient, victim of falling to the ground, was admitted to the Emergency Department with complaints of pain in his right elbow. The patient was submitted to radiographic exams of the elbow, interpreted by the physician as normal. Two weeks later, the patient returned with pain, and radiographic exams of the forearm showed the presence of ulna bowing associated with dislocation of the radial head. As a treatment, we opted for open reduction and fixation of the radial head with metallic wires, associated with flexion osteotomy of the ulna. It evolved in the postoperative period with consolidation of the osteotomy, maintenance of the reduction of the radial head, and recovery of the total range of motion of the elbow and forearm. Conclusion: Pediatric patients who present with pain in the elbow, due to a fall, should be thoroughly evaluated for the possibility of ulna bowing associated with dislocation of the radial head. Ulna osteotomy with fixation of the radial head, without reconstruction of the annular ligament, brought good results in the treatment of neglected Monteggia fracture in a child with ulna bowing. Keywords: Monteggia fracture, Ulna/deformities, Ulna fractures, Osteotomy, Trauma, Child, Pediatrics

show abstract

“…Pediatric Monteggia fracture-dislocations are rare and complex childhood fractures, and new variants of this injury can have more complex presentations. Open reduction and internal fixation addressing all components of the injury will lead to an excellent outcome [ 6 , 7 , 8 , 9 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

A New Pediatric Monteggia Fracture Type 4 Variant

Saleh¹

2021

JOCR

View full text Add to dashboard Cite

Introduction: Monteggia fracture-dislocations are rare and complex injuries that usually involve a fracture of the proximal ulna associated with a proximal radioulnar and radiocapitellar joint dislocations. These injuries comprise <1% of all pediatric forearm fractures. We report on a pediatric Monteggia fracture-dislocation variant that included an irreducible divergent ulnohumeral joint dislocation, an irreducible anterior radial head dislocation, and a proximal and distal radius and ulna fracture. Case Report: A 6-year-old female came to our emergency room with a right elbow and forearm pain and deformity after a fall from a slide on the same day. X-rays revealed a divergent ulnohumeral joint dislocation, an anterior radiocapitellar joint dislocation, a proximal radioulnar joint dislocation, and a proximal and distal ulna and radius fracture. Closed reduction under sedation in the emergency room was not successful, with persistent ulnohumeral, ulnoradial, and radiocapitellar joint dislocations. The patient was taken to the operating room the next morning. She underwent open reduction and internal fixation of the proximal ulna fracture with a one-third tubular locking plate, and radial head dislocation open reduction. A stable reduction of the ulnohumeral joint was only possible after the fixation of the proximal ulna fracture. The most stable position for the radiocapitellar joint after its open reduction was at 70o of elbow extension and full forearm supination; the patient was casted in that position for 6 weeks. Conclusion: Pediatric Monteggia fracture-dislocations are rare and complex childhood fractures, and new variants of this injury can have even more complex presentations. Open reduction and stable internal fixation addressing all components of this injury will lead to an excellent outcome. Keywords: Pediatric monteggia fracture-dislocation, new type four variant, divergent ulnohumeral joint dislocation, irreducible dislocation.

show abstract

Surgical Reconstruction of Missed Monteggia Lesions in Children

Cited by 15 publications

References 26 publications

Fractures-luxations de Monteggia chez l´enfant: étude rétrospective de 40 cas dans le Département d´Orthopédie, Centre Hôpital Universitaire Habib Bourguiba de Sfax, Tunisie

Fractures-luxations de Monteggia chez l´enfant: étude rétrospective de 40 cas dans le Département d´Orthopédie, Centre Hôpital Universitaire Habib Bourguiba de Sfax, Tunisie

Osteotomia da ulna para correção cirúrgica de fratura de Monteggia negligenciada em criança com deformidade plástica da ulna. Relato de caso / Ulna osteotomy for surgical correction of neglected Monteggia fracture in a child with ulna bowing. Case report

A New Pediatric Monteggia Fracture Type 4 Variant

Contact Info

Product

Resources

About