Indirect Reduction of the Radial Head in Children With Chronic Monteggia Lesions
- 송광순; 배기철; 조철현; 이경재; 손은석
- Alternative Author(s)
- Song, Kwang Soon; Bae, Ki Cheor; Cho, Chul Hyun; Lee, Kyung Jae; Son, Eun Seok
- Publication Year
- 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.
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
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
Level of Evidence: Therapeutic Level IV. See Instructions for
Authors for a complete description of levels of evidence.
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