Complications during the treatment of missed Monteggia fractures with unilateral external fixation: a report on 20 patients in a 10-year period in a tertiary referral center

Journal of Pediatric Orthopedics. Part B
Giovanni GalloneGiovanni L Di Gennaro

Abstract

The treatment of a missed Monteggia (MM) fracture dislocation is still controversial. We describe our initial experience with ulnar osteotomy and progressive correction with unilateral external fixator in MM. We retrospectively evaluated 20 children undergoing ulnar osteotomy and progressive distraction angulation by unilateral external fixator to treat MM. Nine patients had closed reduction, whereas 11 patients had simultaneous open reduction, repair, or reconstruction of the annular ligament and K-wire stabilization of the radiocapitellar joint. Patients were followed for an average of 3 (1-11) years. Three children developed aseptic nonunion and one child had delayed union. A distal level of the osteotomy significantly increased the rate of nonunion or delayed union. At the final follow-up, eight children had complete reduction of the radial head, six children had partial reduction, whereas in six cases, the radial head remained dislocated. The angulation and the level of the osteotomy significantly influenced the relocation, whereas the open reduction had no significant effect on the final position of the radial head. At the final follow-up, the Kim's score averaged 93.25. The flexion-extension arc significantly improved po...Continue Reading

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Citations

Jun 17, 2020·The Journal of Bone and Joint Surgery. American Volume·Stewart G MorrisonMark T Dahl
Apr 27, 2020·European Journal of Orthopaedic Surgery & Traumatology : Orthopédie Traumatologie·Sebastian Farr, Giovanni Gallone
Aug 10, 2020·Journal of Pediatric Orthopedics·Kunihiro OkaTsuyoshi Murase
Mar 9, 2021·Journal of Orthopaedics·Tom GrysonFrank Plasschaert
Jul 2, 2021·Journal of Clinical Orthopaedics and Trauma·Om Lahoti, Oluwasegun Akilapa
Jul 21, 2021·Journal of Orthopaedic Trauma·Si Heng Sharon TanJames Hoipo Hui

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