398 581

Cited 25 times in

Impact of Open Reduction on Surgical Strategies for Missed Monteggia Fracture in Children.

Authors
 Hoon Park  ;  Kwang-Won Park  ;  Kun Bo Park  ;  Hyun Woo Kim  ;  Nam Kyu Eom  ;  Dong Hoon Lee 
Citation
 YONSEI MEDICAL JOURNAL, Vol.58(4) : 829-836, 2017 
Journal Title
YONSEI MEDICAL JOURNAL
ISSN
 0513-5796 
Issue Date
2017
MeSH
Adolescent ; Child ; Child, Preschool ; Elbow Joint/diagnostic imaging ; Elbow Joint/physiopathology ; Elbow Joint/surgery ; Female ; Humans ; Male ; Monteggia's Fracture/diagnostic imaging ; Monteggia's Fracture/physiopathology ; Monteggia's Fracture/surgery* ; Open Fracture Reduction* ; Postoperative Care ; Preoperative Care ; Radius/diagnostic imaging ; Radius/surgery ; Range of Motion, Articular ; Retrospective Studies ; Ulna/physiopathology ; Ulna/surgery
Keywords
Missed Monteggia fracture ; open reduction ; ulnar bow ; ulnar osteotomy
Abstract
PURPOSE:

The aims of this study were to review our cases of missed Monteggia fracture treated by open reduction of the radial head with or without ulnar osteotomy and to investigate the indications for open reduction alone in surgical treatment of missed Monteggia fracture.

MATERIALS AND METHODS:

We retrospectively reviewed 22 patients who presented with missed Monteggia fracture. The patients' mean age at the time of surgery was 7.6 years. The mean interval from injury to surgery was 16.1 months. The surgical procedure consisted of open reduction of the radiocapitellar joint followed by ulnar osteotomy without reconstruction of the annular ligament. The mean period of follow-up was 3.8 years. Radiographic assessment was performed for the maximum ulnar bow (MUB) and the location of the MUB. Clinical results were evaluated with the Mayo Elbow Performance Index and Kim's scores.

RESULTS:

Five patients underwent open reduction alone, and 17 patients underwent open reduction and ulnar osteotomy. When the MUB was less than 4 mm and the location of the MUB was in the distal 40% of the ulna, we could achieve reduction of the radial head without ulnar osteotomy. The radial head was maintained in a completely reduced position in 21 patients and was dislocated in one patient at final follow-up.

CONCLUSION:

Open reduction alone can be an attractive surgical option in select patients with missed Monteggia fracture with minimal bowing of the distal ulna. However, ulnar osteotomy should be considered in patients with a definite ulnar deformity.
Files in This Item:
T201702084.pdf Download
DOI
10.3349/ymj.2017.58.4.829
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Hyun Woo(김현우) ORCID logo https://orcid.org/0000-0001-8576-1877
Park, Kun Bo(박건보) ORCID logo https://orcid.org/0000-0002-8839-4870
Park, Hoon(박훈) ORCID logo https://orcid.org/0000-0002-8063-3742
Eom, Nam Kyu(엄남규)
Lee, Dong Hoon(이동훈)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/160317
사서에게 알리기
  feedback

qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse

Links