The Three Step Approach to the management of acute pediatric Monteggia lesions.

Injury
Judit Réka HetthéssyTamás Kassai

Abstract

The literature places the occurrence of paediatric Monteggia lesions between 1.5% and 3% of all childhood elbow injuries. There are circumstances, which may make early correct diagnosis difficult. Failure to make an early correct diagnosis may have catastrophic consequences on joint range of motion in the chronic stage. The goal of this paper is to describe our three-step approach to the treatment of acute Monteggia lesions based on the stability and radiological appearance of the fracture dislocation, to give an overview of possible pitfalls and clinical and radiological signs that aid the diagnostic process. Retrospective analysis of 23 patients treated for this type of injury at our Department over a period of 6 years was performed. Treatment options were 1. Closed reduction under image intensifier followed by immobilization in over the elbow cast, 2. Open reduction and intramedullary nailing with ESIN, or 3. Open reduction and plate osteosynthesis. Average follow-up was 37 months. In our Department we aim for definitive treatment of fracture-dislocations in children within the acute setting. In the 23 acute cases, the selected procedure-reduction+casting/reduction+ESIN/reduction+plating - was performed within 2 to 16 h of a...Continue Reading

References

Jan 5, 2002·Emergency Medicine Journal : EMJ·V K Peter
Jun 21, 2011·The Open Orthopaedics Journal·Nikolaos K Sferopoulos

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