![]() ![]() Discussion: Current evidence regarding reconstruction surgery in chronic Monteggia fractures is level IV and suggests that different surgical techniques are associated with improved function but are associated with a high rate of complications. Complication rate was significantly inferior in group B, 50, 25 and 43.7% respectively (p = 0.0022). The most challenging part of the surgical. Group B improved 30° and 18° respectively. They have been successfully managed surgically with reduction and internal fixation using plates (DCP in all cases). Group A showed a mean improvement of flexion-extension of 20° and decreased pronation-supination 10o. Group B showed a tendency to regain a higher range of motion than groups A and C. The sample consisted of 241 patients (11-33): 22 patients in group A, 84 in group B, and 135 in group C. The treatment of a missed Monteggia fracture remains challenging, as reflected by the numerous surgical procedures described, including ulnar osteotomy, open reduction of the radial head dislocation with or without annular ligament reconstruction (ALR), radial osteotomy, and radial head excision at the end of the growth 4, 5, 7-10. According to NOS the average score was 8.7 points (8.4-9.5). cardiovascular medicine dermatology diabetes and endocrinology ear. Results: We analyzed 17 studies that met our inclusion criteria. diagram of a Monteggia fracture dislocation. Two researchers according to The Newcastle -Ottawa Scale (NOS) assessed the quality of evidence independently. We divided the patients into three groups according to treatment received: A) Reconstruction of the annular ligament, B) Osteotomy of the ulna and C) Combination of both techniques. We analyzed English-language studies that evaluated functional outcomes in patients less than 18 years with 1-year minimum follow-up. Methods: We reviewed the literature for all studies of surgical treatment of chronic Monteggia fractures. The open fractures, comminuted fractures and long oblique fractures need surgical intervention open reduction and internal fixation with screws and plates. Bado classified Monteggia lesions into four types based mainly on the direction of dislocation of the radial head. We conducted a systematic review of the literature to: define the level of evidence regarding reconstruction surgery, determine whether surgery improves function, and identify complications related to each treatment method. A Monteggia lesion is a dislocation of the radial head associated with a fracture of the ulnar shaft. Several techniques are described for the surgical treatment of this condition. When diagnosed late represent a major challenge for the surgeon. All rights reserved.Monteggia, annular ligament reconstruction, osteotomy ulna children.ĪBSTRACT Introduction: Monteggia fractures are rare. This article will cover commonly used fixation techniques for Monteggia fractures with a comprehensive literature review, including technical tips, outcomes, and complications.Ĭoronoid fracture Monteggia elbow fracture-dislocation elbow instability radial head fracture.Ĭopyright © 2021 American Society for Surgery of the Hand. Multiple operative techniques have been described to address the broad spectrum of injuries seen in Monteggia fractures. Access to the critical coronoid fragment can be problematic from the posterior approach and may result in tenuous reduction and fixation, directly affecting the functional outcome. The Jupiter classification captures this injury pattern as a subgroup of Bado posterior Monteggia lesions. While this study demonstrated that the vast majority of patients do well after reconstruction, timely and accurate diagnosis of acute Monteggia fractures. ![]() ![]() The Bado classification describes the direction of the radial head dislocation, and the Jupiter classification further defines. These injuries affect children and adults alike, with specific management options in each subset. The presence of radial head/neck fracture and comminution of the proximal ulna with coronoid involvement elevates the complexity of surgical reconstruction considerably. Monteggia fractures classically involve a proximal ulna fracture with an associated radial head dislocation. Methods: Twenty-eight patients were followed during 55.6 ± 32. For non-emergency walk-in care, try an ExpressCARE location. Background: We aimed to analyze surgical outcomes of reconstructive surgery for chronic Monteggia fracture, which is one of the most challenging problems for orthopaedic surgeons. Monteggia fractures classically involve a proximal ulna fracture with an associated radial head dislocation. Need Immediate Care For emergency services, call 911. ![]()
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