Inveterate Monteggia Injury. Results of 3 cases with the modified Bell-Tawse procedure

Abstract

Purpose Monteggia injuries are a rare occurrence (2% of all elbow fractures), and inveterate cases are extremely unusual. We present 3 cases treated by means of open reduction and reconstruction of the annular ligament with a strip of triceps fascia. Materials and methods The mean age of the 3 patients was 7 years (range: 5-9). Two of them were male and all presented with type 1 Bado injuries on the right side. All 3 were treated by means of the Bell Tawse technique as modified by Lloyd-Roberts and Bucknill; one of the patients was also subjected to ulnar osteotomy. Results There were no complications. After a mean follow-up of 35 months (range: 9-84) all patients achieve a functional flexion-extension range. They experienced a slight loss of pronosupination but they reported no restrictions to their activities of daily living or any functional impairment. Conclusions The modified Bell-Tawse technique is an effective method, even if it leads to a slight loss of mobility, especially in terms of pronosupination. The long-term results of this technique are better than those achieved with a late excision of the dislocated radial head.