Long-Term Clinical and Radiographic Outcomes After Open Reduction for Missed Monteggia Fracture-Dislocations in Children

Nakamura, Koichi; Hirachi, Kazuhiko; Uchiyama, Shigeharu; Takahara, Masatoshi; Minami, Akio; Imaeda, Toshihiko; Kato, Hiroyuki
June 2009
Journal of Bone & Joint Surgery, American Volume;Jun2009, Vol. 91-A Issue 6, p1394
Academic Journal
Background: There have been few reports on the long-term outcomes after the operative treatment of missed Monteggia fracture-dislocations in children. The purpose of the present study was to evaluate the long-term clinical and radiographic outcomes after open reduction for the treatment of a missed Monteggia fracture-dislocation. Methods: We postoperatively investigated the clinical and radiographic outcomes for twenty-two children with a missed Monteggia fracture. The study group included fourteen boys and eight girls who had had a mean age often years (range, four years to fifteen years and eleven months) at the time of open reduction. Each patient had been managed with open reduction of the radial head combined with a posterior bending elongation ulnar osteotomy and anular ligament reconstruction. Clinical and radiographic outcomes were reviewed over a mean duration of follow-up of seven years. Results: The postoperative Mayo Elbow Performance Index at the time of follow-up ranged from 65 to 100, with nineteen excellent, two good, one fair, and no poor results. The radial head remained in a completely reduced position in sever~teen patients and was subluxated in five patients at the time of the latest follow-up. In four patients, osteoarthritic changes were observed at the radiohumeral joint. Radiographically, there were fifteen good, seven fair, and no poor results. A good radiographic result was obtained in all of the patients who had undergone open reduction within three years after the injury or before the age of twelve years, whereas a fair result was obtained in seven of the remaining eight patients. Conclusions: If open reduction for the treatment of a missed Monteggia fracture is performed when the patient is less than tweIve years of age or within three years after the injury, good long-term clinical and radiographic outcomes can be expected.


Related Articles

  • Transphyseal Anterior Cruciate Ligament Reconstruction in the Skeletally Immature. Kumar, Sujit; Ahearne, David; Hunt, David M. // Journal of Bone & Joint Surgery, American Volume;1/2/2013, Vol. 95-A Issue 1, p35 

    Background: The evidence in favor of early surgical treatment of anterior cruciate ligament (ACL) injuries in children is increasing. However, the controversy regarding the safety of such a procedure in young athletes with wide open physes remains unresolved. Methods: We reviewed prospectively...

  • TIBIAL SPINE AVULSIONS IN THE SKELETALLY IMMATURE. Vermesan, D.; Prejbeanu, R.; Haragus, H.; Vermesan, S.; Damian, G. // Jurnalul Pediatrului;Jul-Dec2012, Vol. 15 Issue 59/60, p59 

    In children, displaced avulsions of the tibial spine are equivalent to ruptures of the anterior cruciate ligament. They present to general orthopaedists as well as a wide variety of orthopedic subspecialty surgeons including sports medicine and pediatrics. Restoration of normal knee kinematics...

  • Imaging of traumatic dislocation of the hip in childhood. Vialle, Raphaël; Pannier, Stéphanie; Odent, Thierry; Schmit, Pierre; Pauthier, François; Glorion, Christophe // Pediatric Radiology;Dec2004, Vol. 34 Issue 12, p970 

    Examines a retrospective series of traumatic hip dislocations in children. Prevalence of road traffic accident as cause of dislocations; Types of fractures sustained; Importance of analysis of plain radiographs before and after reduction of the joint and postreduction CT in patients whose joint...

  • Comparison of Manual and Gravity Stress Radiographs for the Evaluation of Supination-External Rotation Fibular Fractures. Gill, J. Brian; Risko, Timothy; Raducan, Viorel; Grimes, J. Speight; Schutt, Jr., Robert C. // Journal of Bone & Joint Surgery, American Volume;May2007, Vol. 89-A Issue 5, p994 

    Background: Isolated distal fibular fractures most commonly result from a supination-external rotation injury of the ankle. Deltoid ligament ruptures can also be associated with these injuries, resulting in an unstable ankle fracture due to incompetent lateral and medial restraints. We...

  • Stress Radiography for the Diagnosis of Knee Ligament Injuries: A Systematic Review. James, Evan; Williams, Brady; LaPrade, Robert // Clinical Orthopaedics & Related Research;Sep2014, Vol. 472 Issue 9, p2644 

    Background: Stress radiography is a widely used diagnostic tool to assess injury to the anterior and posterior cruciate ligaments and the medial and lateral structures of the knee. However, to date, numerous techniques have been reported in the literature with no clear consensus as to which...

  • Difficulties with knees. Lightowler, C.D.R. // British Medical Journal (Clinical Research Edition);7/16/1983, Vol. 287 Issue 6386, p165 

    Investigates on difficulties with knees. Diagnosis of internal derangement which led to arthrotomy; Rupture of cruciate ligaments; Procedures of treatment; Use of radiographs in the detection of fragment.

  • Modified Carpal Stretch Test as a Screening Test for Detection of Scapholuñate Interosseous Ligament Injuries Associated with Distal Radial Fractures. Bong Cheol Kwon; Soo-Joong Choi; Si-Young Song; Sang Hoon Back; Goo Hyun Back // Journal of Bone & Joint Surgery, American Volume;5/4/2011, Vol. 93-A Issue 9, p855 

    Background: Intra-articular distal radial fractures are frequently accompanied by a scapholunate interosseous ligament injury, which may adversely affect the outcomes. Arthroscopy may not be appropriate as a first-line evaluation method to diagnose these injuries because of time, expense, and...

  • Type IV Monteggia fracture in a child. Agarwal, Anil // Canadian Journal of Surgery;Apr2008 Supplement, Vol. 51, pE44 

    The article presents a case study of a 12-year-old boy who suffered injuries to his left forearm and elbow in a fall from a bicycle. A type IV Monteggia lesion was revealed on radiographs of the patient's affected elbow. This type of lesion shows that the radial fracture is minimally displaced...

  • Ipsilateral posterior sternoclavicular dislocation and fracture of the medial third clavicle: a case report. Mounasamy, Varatharaj; Fleming, Mark; Birnbaum, Mark // European Journal of Orthopaedic Surgery & Traumatology;Dec2006, Vol. 16 Issue 4, p351 

    Ipsilateral fracture of the medial third clavicle and posterior dislocation of Sternoclavicular joint is an extremely rare presentation. This case report illustrates an 11-year-old male patient with ipsilateral fracture of the medial third clavicle and posterior Dislocation of the...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics