Treatment Of Monteggia Fractures Research Articles

Outcomes using the Ilizarov external mini-fixator for Monteggia fractures in children

Objective To evaluate the use of Ilizarov external mini-fixation in the treatment of Monteggia fractures (dislocation of the radial head with an associated fracture of the proximal ulna) in children. Methods Children with proximal ulnar fracture were included and underwent fracture reduction surgery with Ilizarov external mini-fixators, followed by immobilization of the supinated forearm with plaster. The reduction was evaluated intra-operatively using arthrography. Mackay criteria were used to evaluate clinical outcomes at follow-up. Results A total of 15 children were included in the study. Mackay efficacy was 100 %, indicating excellent outcomes using the Ilizarov external mini-fixator. Conclusion Use of the Ilizarov external mini–fixator is particularly suitable in the treatment of children with comminuted and compression fractures of proximal ulna. It is easy to operate, low invasive and is worthy of promotion.

Outcomes of Treatment of Monteggia Fractures with Reduction and Internal Titanium Elastic Nail Fixation of the Ulna.

The purpose of this paper is to evaluate the usefulness of radiographic indices of humero-radial joint instability in order to predict treatment outcomes in Monteggia fractures. A retrospective analysis was conducted in a group of patients who underwent closed reduction and internal titanium elastic nail (TEN) fixation of the ulna and closed reduction of a dislocation of the radial head between 2016 and 2018. The indications for intrame-dullary fixation comprised transverse or short oblique fractures. The direction of the dislocation was classified according to Bado. The following radiographic indies were assessed: Radiocapitellar Line, Lateral Humeral Line, Proximity Index, and Radial Head Displacement Index. Treatment outcomes were assessed with the Oxford Elbow Score and Mayo Elbow Performance Score, and com-plications were assessed with a modified Clavien-Dindo-Sink scale. No coincidence between poor functional and radio-graphic outcomes was demonstrated. 1. Regardless of the severity of the injury, eligibility for surgery and correctly performed surgical treatment guarantee a good final outcome. 2. Patients treated with TEN regain their preoperative mobility. 3. There was no coincidence between poor functional and radiographic outcomes, except for one patient in whom subluxation of the radial head persisted despite surgery and was confirmed radiographically and functionally. 4. It would be beneficial for clinical practice to introduce simple, reproducible radiographic parameters for unambiguous assessment of the effectiveness of treatment and predicting treatment outcomes; unfortunately none of the parameters we investigated were sufficiently reliable. 5. The radiographic parameters analysed in this paper are dependent on the quality of the radiological examinations performed.

Treatment of Monteggia fracture in children

Treatment of Monteggia fracture in children

Ulnar Intramedullary Fixation in the Treatment of Acute Pediatric Monteggia Fractures: To Bury or Not

Purpose: Pediatric Monteggia fractures often require surgical intervention to stabilize the ulna and maintain reduction of the radiocapitellar joint. There is a paucity of research comparing ulnar percutaneous intramedullary fixation to buried intramedullary fixation in acute pediatric Monteggia fractures. This study analyzes the difference between the two types of ulnar intramedullary fixation. We hypothesized that percutaneous fixation yields equivalent results to buried intramedullary fixation while eliminating a second surgery for hardware removal. Methods: A retrospective review identified patients who suffered …

Treatment of Monteggia fracture in children

Treatment of Monteggia fracture in children

Application of elastic stable intramedullary nail in treatment of pediatric Monteggia fractures

Objective To discuss the indications,surgical techniques and prognosis of pediatric Monteggia fractures treated with elastic stable intramedullary nail (ESIN).Methods In the period between January 2005 to December 2012,27 children with Monteggia fractures were treated with ESIN and completely followed up by authors.They were 15 boys and 12 girls,aged from 4.0 to 13.3 years (average,7.3 years).The injury affected 12 left sides and 15 right sides.According to the Bado classification system,19 cases were of type Ⅰ,5 of type Ⅲ and 3 of type ⅣV.In Bado types Ⅰ and Ⅲ,the ulnar fractures were treated with closed reduction and internal fixation using ESIN.In 2 cases of Bado type Ⅳ,fractures of the ulna and radius were fixated with ESIN.In another case of Bado type Ⅳ,the ulnar facture was fixated with plate and the radial fracture with ESIN.The radiohumeral joints were treated with open reduction in only 2 cases,and with closed reduction in the rest.The reduction was evaluated by the postoperative X-ray films and the therapeutic outcomes were assessed by the Bruce-Harvey-Wilson evaluation system.Results The follow-up period ranged from 10 months to 31 months (average,18 months).All fractures united without infection,myositis ossificans,Volkmann ischemic contracture or skin irritation.Complete healing (mature callus and medullary cavity recanalization) was achieved after 12 to 33 weeks (average,20 weeks).According to the postoperative radiographs,22 cases were considered excellent and 5 cases good.According to the Bruce-Harvey-Wilson scoring system,26 cases were considered excellent and one good.Conclusion Since the technique of ESIN is simple,practical and minimally invasive,and leads to fewer complications,it is an effective treatment for pediatric Monteggia fractures,especially after failed conservative management and for those associated with Gustilo type Ⅰ open wound. Key words: Ulna fractures; Fracture fixation, intramedullary; Child

Ulnar oblique osteotomy followed by plating versus no plating in treatment of obsolete Monteggia fractures in children

Objective To compare the clinical efficacy of plating versus non-plating following ulnar oblique osteotomy in the treatment of obsolete Monteggia fractures in children.Methods Clinical data of 33 patients were reviewed who had been treated for obsolete Monteggia fracture in our department from January 2001 to June 2011.They were 23 males and 10 females,aged from 4 to 13 years (average,8.1 years).According to the Bado classification,23 cases were type Ⅰ,4 type Ⅱ and 6 type Ⅲ.Ulnar oblique osteotomy was performed in all the 33 cases to extend the ulna lengthways,but their subsequent fixation was different.In the non-plating group (17 cases),after reduction of the radial head,a supplementary transfixation of the radius was performed with a Kirschner wire through the capitellum,and the excised ulna was free of fixation.In the plating group (16 cases),after transfixation of the radius with a Kirschner wire through the capitellum,plating was performed of the excised ulna.Both groups were immobilized in a plaster cast after surgery.The 2 groups were compared with respect to healing time for the ulnar osteotomy and the Mackay scoring for postoperative elbow function.The 2 groups were comparable with no significant difference in the general data (P ＞ 0.05).Results Follow-ups for an average of 1.5 years (from 10 months to 3 years) revealed no incision infection and ulnar healing in all the patients.The average ulnar healing time for the non-plating group (7.2 ± 1.1 weeks) was significantly shorter than for the plating group (8.5 ± 1.8 weeks) (P ＜ 0.05).In the non-plating group,l0 cases were rated as excellent,5 good and 2 poor; in the plating group,11 cases were rated as excellent,4 good and one poor.In either of the 2 groups,3 cases reported residual pain in elbow motion.The non-plating group reported one case of dislocation of the capitellum.Conclusion Non-plating after ulnar osteotomy may be used as a treatment of obsolete Monteggia fractures in children,because it has advantages of less invasion to the ulnar blood supply,shortened operation time and healing time. Key words: Forearm injuries; Osteotomy; Fracture fixation, internal; Child

Repair of Monteggia Fractures Using an Arthrex Tightrope System and Ulnar Plating

To report the outcome after treatment of Monteggia fractures (MF) using a novel surgical technique. Clinical reports. One dog and 1 cat were treated for MF by use of a Tightrope suture, toggle, and button implant. In both patients the fracture/luxations were reduced using an open technique and the tightrope was placed using a cannulated drill system and guide wire from cranial to caudal. Cases were retrospectively reviewed at 1, 5, and 8 weeks (cat) and at 4 weeks and 4 months (dog) for complications and outcome. Outcomes were measured by subjective assessment of range of motion comparing affected to unaffected limbs, and lameness scoring and by client description of function. Both animals returned to normal function with range of motion close to that of the unaffected limb. No complications were recognized. Tightrope repair of MF resulted in excellent clinical results with no complications.

The treatment of Monteggia fractures in children

The treatment of Monteggia fractures in children

Treatment of missed Monteggia fractures in children with dual-socket external fixators

Objective To discuss the treatment of missed Monteggia fractures in children with du-al-socket external fixators. Methods Seven patients, 6 boys and 1 girl, with missed Monteggia fracture were treated by dual-socket external fixators (Device of the wrist joint, s/n 37000, Orthofix Co., England). Their average age was 7.9 (3.5 to 11) years. Intervals between injury to operation averaged 11.7 (1 to 30) months. X-ray showed excessive growth of the radius and volar or even radial angulation of the ulna besides dislocation of the radial head. The radiohumeral joint was reached through Henry approach and any interposed tissues were cleaned. Then, oblique osteotomy at 30 degrees was performed in the proximal ulna. Once the Orthofix dual-socket fixator set properly, lengthening and then corrective angulating as well as real-time ad-justing of the osteotomy site of the ulna, according to the radiocapiteUar congruity at pronation, neutral posi-tion, and supination of the forearm, were managed under a fluoroscope. When concentric reduction was achieved, the radiocapitellar relation was secured by the repair of the annular ligament if its remnant could be dehrlded from the interposed scar in the radiohumeral space. A long-ann plaster splint was applied after op-eration and was maintained for 2 to 3 weeks. Removal of the fixator was clone only when the osteotomy site of the ulna had already got bony healing. Results All 7 patients were followed up between 3 to 26 months, with bony healing of the ulna, good radiocapitellar relationship and painless elbow joint. According to Morrey criteria, there were 6 good and 1 fair results. Conclusions Orthofix dual-socket fixators can effectively maintain the required location of the ulna after osteotomy and stabilize the proper correlation of the radio-humeral joint. Their advantages include easy adjustment during operation or even postoperatively, and early exercise of the elbow and forearm due to their finn fixation. Key words: Children; Fracture, missed; External fixators

Diagnosis and Treatment of Monteggia Fracture in Children

Diagnosis and Treatment of Monteggia Fracture in Children

Treatment of Monteggia Fracture in Adult

Treatment of Monteggia Fracture in Adult

Treatment of Monteggia fracture in Adults

Treatment of Monteggia fracture in Adults

The Diagnosis and Treatment of Monteggia Fractures

s: Proceedings of the 35th Annual Meeting of the American Fracture Association,1974: PDF Only

End results in the treatment of Monteggia fractures. A follow-up study of twelve cases.

End results in the treatment of Monteggia fractures. A follow-up study of twelve cases.