scholarly journals Outcome of Monteggia Fracture Dislocation in Children Treated With K Wires in Nepalgunj Medical College

2022 ◽  
Vol 19 (1) ◽  
pp. 59-63
Author(s):  
Sabin Shrestha ◽  
Dinesh Kumar Shrestha
Keyword(s):  
Functional Outcome ◽  
Radial Head ◽  
Early Mobilization ◽  
Fracture Dislocation ◽  
Monteggia Fracture ◽  
Rigid Fixation ◽  
Cross Sectional ◽  
Medical College ◽  
K Wires ◽  
Monteggia Fracture Dislocation

Introduction: Monteggia fracture dislocations are rare injuries (<5%) where missed treatment results into deformity and dysfunction of forearm and hand. For the better functional result early diagnosis, accurate reduction of radial head and rigid fixation of ulna and immobilization during post-operative period for ligamentous healing around radius is vital. So operative treatment has been the primary method of treatment to prevent deformity and disability in monteggia fracture dislocation. Aims: The aim of this study was to evaluate the time taken to unite fractures, complications encountered and assess the functional outcome on the basis of K-wire fixation in monteggia fracture dislocation in children. Methods: A cross-sectional observational study was conducted in Nepalgunj Medical College and Teaching Hospital, Kohalpur, Banke with monteggia fracture dislocation in children. Results: Thirty-two monteggia fracture dislocation in children between six to 14 years of age were treated with intramedullary K-wires after reduction of radial head. Seven cases had open reduction, and five needed trans-capitellar K-wire supplementation. Mean union time was 8.44±1.94 weeks ranging from seven to 12 weeks. The functional outcome on the basis of Anderson’s scoring system was excellent in 25(78.1%), good in three and optimal in four cases. Conclusion: Monteggia fracture dislocation is better treated early and early mobilization of elbow joint is needed for better functional results.

scholarly journals Monteggia fracture dislocation in adults: study of functional outcome following surgical treatment in patients attending a tertiary care center in North India

2017 ◽  
Vol 5 (7) ◽  
pp. 2975
Author(s):  
Shameem A. Khan
Keyword(s):  
Functional Outcome ◽  
Radial Head ◽  
Closed Reduction ◽  
Fracture Dislocation ◽  
Monteggia Fracture ◽  
Rigid Fixation ◽  
X Rays ◽  
Compression Plate ◽  
Monteggia Fracture Dislocation ◽  
Mean Time

Background: Monteggia fracture dislocations are rare injuries that comprise less than five percent of all forearm fractures. Good results in monteggia fractures depend on early and accurate diagnosis, rigid fixation of ulna, accurate reduction of radial head and post-operative immobilization to allow ligamentous healing about the dislocated radial head. The objectives of the study were to assess the mean time taken for union of fracture, complication encountered during treatment, to assess the functional outcome and to present conclusions based on the results of plate osteosynthesis of monteggia fracture dislocation in adults.Methods: In a prospective study from September 2013 to August 2016, twenty adult patients of monteggia fracture were admitted and treated by closed reduction/excision of radial head and compression plate fixation of ulna. The results were evaluated by assessing union on serial x-rays at follow-up (6-18 months) and functional outcome using Anderson’s criteria.Results: Most of the cases were type-1 fracture-dislocation according to Bado's classification. Mean time taken for union was 4.1 months. Using Anderson scoring system, we achieved 65% excellent results, 30% satisfactory result and 5% failure in study case. The complication encountered were superficial infection and non-union.Conclusions: The technique of early closed reduction of radial head and open reduction and internal fixation of ulna using compression plate is a simple and effective means of treating monteggia fracture dislocation in adults with excellent functional outcome. Upper limb should be immobilized in 110-120 degrees of elbow flexion and forearm in supination to prevent radial head redislocation.

scholarly journals Step-cut osteotomy in neglected Monteggia fracture dislocation in pediatric and adolescent patients: A retrospective study

2020 ◽  
Vol 28 (3) ◽  
pp. 230949902096408
Author(s):  
Chetan Peshin ◽  
Rohan Ratra ◽  
Anil Kumar Juyal
Keyword(s):  
Retrospective Study ◽  
Range Of Motion ◽  
Radial Head ◽  
Bone Grafting ◽  
Ligament Reconstruction ◽  
Fracture Dislocation ◽  
Annular Ligament ◽  
Monteggia Fracture ◽  
Annular Ligament Reconstruction ◽  
Monteggia Fracture Dislocation

Introduction: Neglected Monteggia fracture dislocation in children leads to significant restriction of daily activities by causing decreased range of motion at elbow, stiffness, deformity, and neurological compromise. Various treatment strategies have been described in the literature and one of them is ulnar osteotomy combined with reduction of radial head and annular ligament reconstruction. Aim: The aim of this study was to evaluate the results of step-cut osteotomy without the use of bone grafting with reconstruction of annular ligament in the management of neglected Monteggia fracture dislocation in children. Materials and Methods: A retrospective study was conducted in six patients with neglected Monteggia fracture dislocation with a mean age of 8.83 years. The median interval between the original injury and the corrective surgery for 6 patients was 4.4 months (range 1–12 months). All children underwent step-cut osteotomy of ulna, open reduction of radial head, and annular ligament reconstruction. Mayo Elbow Performance Index (MEPI) score was used for evaluation. Results: The ulnar osteotomies healed uneventfully without the need for a bone graft. Elbow range of motion improved post-op along with improved elbow functioning as indicated by raised MEPI score. The MEPI score was excellent in 5 cases and fair in 1 case. Conclusion: Step-cut osteotomy alone without the use of bone grafting and reinforcement with annular ligament repair is a simple yet effective technique for treating neglected Monteggia fracture dislocation.

scholarly journals CHRONIC MONTEGGIA FRACTURE-DISLOCATION IN CHILDREN SURGICAL STRATEGY AND RESULTS

2019 ◽  
Vol 27 (5) ◽  
pp. 244-247
Author(s):  
Jamil Faissal Soni ◽  
Weverley Rubele Valenza ◽  
Carolina Umeta Matsunaga ◽  
Anna Carolina Pavelec Costa ◽  
Fernando Ferraz Faria
Keyword(s):  
Radial Head ◽  
Kirschner Wire ◽  
Surgical Techniques ◽  
Lateral Approach ◽  
Fracture Dislocation ◽  
Monteggia Fracture ◽  
Level Of Evidence ◽  
The Mean ◽  
Monteggia Fracture Dislocation

ABSTRACT Objective: To report surgical techniques and results in the treatment of chronic Monteggia fracture-dislocation in children. Methods: Six pediatric patients who had undergone a procedure involving the following 6 crucial surgical steps were retrospectively evaluated: 1- extended lateral approach, 2- fibrotic removal, 3-proximal ulnar osteotomy, 4- reduction of the radial head and transcapitellar temporary fixation, 5- ulnar fixation with a straight plate shaped according to the deformity generated by temporary fixation, and 6- transcapitellar Kirschner wire removal. Results: Four patients were women, and four showed the right-sided compromise. The mean age of patients was 8 years, and the minimum follow-up period was 12 months. The mean time from the onset of fracture to treatment was 6 months. Six patients underwent complete flexo/extension, and one patient had a complete prono-supination. In four patients, we observed loss of pronation (by 10° in two, 15° in one, and 20° in one), and one patient had a 15° decrease in supination. We did not observe any redislocation of the radial head in the follow-up evaluation. No complications were observed; the only complaint was salience of the ulnar plate. Conclusions: Our results demonstrated an effective option for the treatment of chronic Monteggia fracture-dislocation in children, even with a small study sample, following the presented technical and surgical strategies. Level of evidence IV, Therapeutic Studies.

scholarly journals Irreducible Radial Head in Monteggia Fracture Dislocation; Is there an Alternative to Open Reduction?

2021 ◽  
Vol 4 (7) ◽  
pp. 10-15
Author(s):  
Amr A Abdelgawad ◽  
Aaron J Wey ◽  
Rami Khalifa ◽  
Saad Shoulah ◽  
Ahmed M Thabet
Keyword(s):  
Radial Head ◽  
Open Reduction ◽  
Fracture Dislocation ◽  
Monteggia Fracture ◽  
Monteggia Fracture Dislocation
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