Missed radial head dislocations in children associated with ulnar deformation: treatment by open reduction and ulnar osteotomy.

Abstract

OBJECTIVE:

To evaluate the results of open reduction and ulnar osteotomy on missed Monteggia fractures in children.

DESIGN:

Retrospective review.

SETTING:

Tertiary care center orthopaedic hospital in Pellenberg, Belgium.

PATIENTS/PARTICIPANTS:

Six children between 2 and 6 years old who sustained a Monteggia fracture that was initially missed were treated at our institute. They presented in our hospital 5 to 59 weeks postinjury.

INTERVENTION:

Open reduction of the radial head was performed, combined with a dorsal opening wedge osteotomy of the proximal ulna and fixation with plate and screws.

MAIN OUTCOME MEASUREMENTS:

Mobility of the elbow was measured by an independent observer, evaluating flexion-extension and pronation-supination preoperatively and postoperatively.

RESULTS:

All patients regained a normal range of motion, the radial head remained relocated, and the axis of the forearm remained normal.

CONCLUSION:

This operation-open reduction of the radial head and osteotomy of the ulna-results in an excellent outcome for a missed Monteggia fracture in children.

• Authors: I Degreef, L De Smet
• Journal: Journal of orthopaedic trauma (J Orthop Trauma) Vol. 18 Issue 6 Pg. 375-8 (Jul 2004) ISSN: 0890-5339 [Print] United States
• PMID: 15213503 (Publication Type: Journal Article)

Topics

• Child
• Child, Preschool
• Diagnostic Errors
• Elbow Joint (physiopathology)
• Female
• Fracture Fixation, Internal (methods)
• Humans
• Male
• Monteggia's Fracture (complications, diagnostic imaging, surgery)
• Osteotomy
• Radiography
• Range of Motion, Articular
• Retrospective Studies
• Ulna (diagnostic imaging, pathology, surgery)