Acute Pediatric Monteggia Fractures: A Conservative Approach to Stabilization

Journal of Pediatric Orthopedics
Ian ForanAndrew T Pennock

Abstract

In 2015, a multicenter study group proposed a treatment algorithm for pediatric Monteggia fractures based upon the ulnar fracture pattern. This strategy recommends surgical stabilization for all complete ulna fractures. The purpose of this study was to evaluate whether an initial nonoperative approach to pediatric Monteggia fractures resulted in poorer outcomes and a higher rate of complications. This institutional review board approved retrospective study evaluated all Monteggia fractures presenting to a level 1 pediatric trauma center between 2008 and 2014. Chart and radiographic reviews were performed on 94 patients who met inclusion criteria. The mean age was 5.5 years (range, 1 to 13 y). The mean clinical follow-up was 18 weeks. Major complications were defined as those requiring an unplanned second procedure (other than implant removal) or that may result in long-term disability (residual radial head subluxation/dislocation). Univariate (P<0.05) and Multivariate Classification and Regression Tree (CART) (P<0.05) analyses were used to identify variables associated with the need for surgical stabilization. At final follow-up, there were no cases of residual radiocapitellar joint subluxation or dislocation and all fractures ...Continue Reading

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Citations

Jan 8, 2020·Journal of Children's Orthopaedics·M ČepelíkP Havránek
Oct 13, 2020·Hand Clinics·Tyler C Miller, Felicity G Fishman
Jul 20, 2021·JBJS Essential Surgical Techniques·Anthony I RiccioJonathan G Schoenecker

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