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Indirect Reduction of the Radial Head in Children With Chronic Monteggia Lesions

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Author(s)
송광순배기철조철현이경재손은석
Alternative Author(s)
Song, Kwang SoonBae, Ki CheorCho, Chul HyunLee, Kyung JaeSon, Eun Seok
Publication Year
2012
Abstract
Objective: The purpose of this study was to report the long-term
follow-up results of chronic Monteggia fractures treated with
angulation–translation osteotomy of ulna and closed reduction of
the radial head.
Design: Retrospective.
Setting: Level 1 trauma center.
Patients: We retrospectively reviewed 10 missed Monteggia fractures
in children. The mean age of the patients was 7.5 years (range,
6–10 years), and there were 2 girls and 8 boys. The mean duration of
time between initial injury and initial presentation was 1.7 years
(range, 6 weeks to 5 years).
Intervention: Closed reduction with ulna osteotomy or lengthening
was performed in all 10 cases. Annular ligament reconstruction (ALR)
was done in 2 cases. Final follow-up ranged from 3 to 20 years (mean
10 years).
Main Outcome Measurement: We assessed preoperative and
postoperative radiographs to evaluate the quality of the radial head
reduction. Clinical results were assessed according to the functional
elbow score devised by Kim et al.
Results: Radial head reduction was achieved and maintained in 8 of
10 cases after primary or secondary surgery. The radial head was
mildly subluxated in one case and dislocated in another case at final
follow-up. ALR was performed in only 2 cases. Open reduction and
ALR is not required in every case, and its need should depend on
intraoperative stability of radial head.
Key Words: chronic Monteggia lesion, ulna osteotomy, closed
reduction, children
Level of Evidence: Therapeutic Level IV. See Instructions for
Authors for a complete description of levels of evidence.
Department
Dept. of Orthopedic Surgery (정형외과학)
Publisher
School of Medicine
Citation
Journal of orthopaedic trauma, Vol.26(10) : 597-601, 2012
Type
Article
ISSN
0890-5339
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/38534
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