Open Reduction of the Radial Head with Ulnar Osteotomy and Annular Ligament Reconstruction for Bilateral Congenital Radial Head Dislocation: A Case with Long-Term Follow-Up

2007 ◽  
Vol 32 (1) ◽  
pp. 93-97 ◽  
Author(s):  
H. YAMAZAKI ◽  
H. KATO
Keyword(s):  
Radial Head ◽  
Open Reduction ◽  
Ligament Reconstruction ◽  
Annular Ligament ◽  
Radial Head Dislocation ◽  
Results Of Treatment ◽  
Ulnar Osteotomy ◽  
Annular Ligament Reconstruction ◽  
Congenital Radial Head Dislocation

We report the 9 year follow-up results of treatment of a 5 year-old boy with bilateral congenital radial head dislocation by open reduction of the radial head and ulnar osteotomy with annular ligament reconstruction and discuss the management of this condition.

scholarly journals Ulnar osteotomy is the only required procedure for chronic monteggia fracture in children.

2021 ◽  
Vol 28 (06) ◽  
pp. 886-890
Author(s):  
Abdul Latif Shahid ◽  
Farhad Alam ◽  
Islam Hussain ◽  
Abdul Latif Sami
Keyword(s):  
Radial Head ◽  
Open Reduction ◽  
Annular Ligament ◽  
Osteotomy Site ◽  
Time Interval ◽  
Monteggia Fracture ◽  
Ulnar Osteotomy ◽  
Flexion Extension ◽  
Annular Ligament Reconstruction ◽  
Ulnar Lengthening

Objective: To determine containment of radial head after ulnar osteotomy in chronic Monteggia fractures. Study Design: Retrospective study. Setting: Children Hospital and The Institute of Child Health, Lahore. Period: 2019 to January 2020. Material & Methods: Ten patients presented in outdoor patient department with a diagnosis of chronic Monteggia fracture. Four patients were labelled as missed Monteggia fractures, four with late presented Monteggia fractures and two with inadequately treated Monteggia fractures. Bado and Letts classifications were applied for patients. Mean age was 6 years and 8 months and ranged from 4 to 10 years. Mean time interval between injury and admission was 6.1 months. Open reduction of radial head and ulnar osteotomy was done through Boyed approach. Transcapitellar wire was inserted temporarily and then removed so it is not required permanently. The ulnar osteotomy was angulated opposite to the direction of radial head dislocation and fixed with plate and screws. Results: 10 patients were included in this study. The age range was between 4 and 10 years. The study period was six months and follow up was one year. Mean ulnar angulation at osteotomy site was 21.3° (16-25°). Mean ulnar lengthening at osteotomy site was 0.85 cm (0.5-1.8 cm).Improvement in flexion-extension was 20.3%, pronation was 5.1% and supination was 13.7%. Complications included were nounion in 1 case and cubitus valgus in 1 case. Conclusion: Containment of radial head is obtained by open reduction of radial head and with ulnar osteotomy in chronic Monteggia fractures. Annular ligament reconstruction and transcapitellar wire insertion are not required if proper angulation and fixation of ulnar osteotomy is performed. No age limit for this procedure but surgery should be performed before radial head deformation.

scholarly journals Treatment of missed Monteggia fracture with intact annular ligament after an interval of 9 years: a case report and literature review

2020 ◽  
Vol 48 (8) ◽  
pp. 030006052094907
Author(s):  
Weizheng Zhou ◽  
Lianyong Li ◽  
Mingzhang Mu
Keyword(s):  
Functional Outcomes ◽  
Open Reduction ◽  
Ligament Reconstruction ◽  
Annular Ligament ◽  
Monteggia Fracture ◽  
Mature Individual ◽  
Initial Injury ◽  
Annular Ligament Reconstruction ◽  
Missed Monteggia

Objective Missed Monteggia fractures are commonly observed among children. Both the interval from the injury to surgery and the patient’s age at operation are thought to be correlated directly with the success of the surgery and prognosis. The aim of the present work was to report one interesting adult case of a missed Monteggia fracture with an intact annular ligament 9 years after injury and the outcomes at a 7-year follow-up. Case description One missed lesion with a 9-year delay for surgery occurred in a skeletally mature individual, and it was treated by open reduction and ulnar angulation and elongation osteotomy. The annular ligament was interpositioned intact in the radiocapitellar joint, and therefore, instead of the annular ligament reconstruction (ALR), relocation was performed. Results After one revision surgery for the complication of nonunion, good radiographic and functional outcomes were eventually sustained at the 7-year follow up. Conclusion Good radiographic and functional outcomes can be expected in adult patients in whom the annular ligament is intact and interpositioned, and this was treated by open reduction and ulnar osteotomy 9 years after the initial injury in our patient.

The treatment of chronic radial head dislocation in Monteggia fracture without annular ligament reconstruction

2018 ◽  
Vol 42 (9) ◽  
pp. 2165-2172 ◽  
Author(s):  
Hsuan-Yu Chen ◽  
Kuan-Wen Wu ◽  
Zheng-Ren Dong ◽  
Shier-Chieg Huang ◽  
Ken N. Kuo ◽  
...  
Keyword(s):  
Radial Head ◽  
Ligament Reconstruction ◽  
Annular Ligament ◽  
Monteggia Fracture ◽  
Radial Head Dislocation ◽  
Annular Ligament Reconstruction

scholarly journals Ligament Reconstruction for Recurrent Anterior Dislocation of the Radial Head

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Taku Hatta ◽  
Kiyotsugu Shinagawa ◽  
Kou Hayashi ◽  
Kazushige Hasegawa ◽  
Yoshinori Miyasaka ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Radial Head ◽  
Ligament Reconstruction ◽  
Pathological Condition ◽  
Recurrent Dislocation ◽  
Anterior Dislocation ◽  
Annular Ligament ◽  
Internal Brace ◽  
Sports Activities

Isolated recurrent dislocation of the radial head (RH) is very rare, and there have been few reports describing the surgical treatment of this injury. We herein report the case of a 13-year-old girl who underwent ligament reconstruction surgery for isolated recurrent RH dislocation. Her symptoms included pain and apprehension at the elbow with the forearm in supination. A radiologic examination revealed anterior dislocation of the RH with the forearm in supination but complete reduction with the forearm in neutral to pronated positions. Surgical treatment to reconstruct the annular ligament and facilitate the radial collateral ligament was performed using an autograft with internal brace augmentation. At a 12-month follow-up examination, the patient had asymptomatic stability with recovery to sports activities. This case report describes a novel technique for the treatment of a rare pathological condition of the elbow.

A modified Bell-Tawse Proceduter for surgical correction of congenital elbow luxation in a Dalmatian puppy

2001 ◽  
Vol 14 (04) ◽  
pp. 210-213 ◽  
Author(s):  
N. Romagnoli ◽  
A. Venturini ◽  
A. Spadari
Keyword(s):  
Contact Surface ◽  
Radial Head ◽  
Ligament Reconstruction ◽  
Weight Bearing ◽  
Surgical Correction ◽  
Annular Ligament ◽  
Orthopaedic Procedure ◽  
Elbow Luxation ◽  
Annular Ligament Reconstruction ◽  
The Right

SummaryA four month old Dalmatian puppy affected by congenital luxation of the radial head was very lame on the right front limb and was not weight bearing after little exercise. The radiological examination revealed humero-radial articular incongruity, excessive humeral trochlea development, trochlear notch deformation, and medial deviation of the olecranon. The surgery performed was derived from a modification of a human orthopaedic procedure, the Bell-Tawse technique. It was intended to increase the articular contact surface between the humerus and radius, with ostectomy, rotation, and osteosynthesis of the radius; to treat the luxation, by reduction and elbow annular ligament reconstruction; to prevent its recurrence, by means of a Kirschner pin inserted through the lateral humeral epicondyle to the radial head. Over six months the patient completely recovered.A congenital luxation of the radial head in a puppy was treated successfully employing a technique reported in human orthopaedics.

scholarly journals Surgical treatment of chronic anterior radial head dislocations in missed Monteggia lesions in children: A rationale for treatment and pearls and pitfalls of surgery

2019 ◽  
Vol 12 (6) ◽  
pp. 422-431
Author(s):  
LC Langenberg ◽  
ACH Beumer ◽  
B The ◽  
KLM Koenraadt ◽  
D Eygendaal
Keyword(s):  
Range Of Motion ◽  
Radial Head ◽  
Ligament Reconstruction ◽  
Annular Ligament ◽  
Proximal Ulna ◽  
Monteggia Lesion ◽  
Ulna Osteotomy ◽  
Annular Ligament Reconstruction ◽  
Monteggia Lesions ◽  
Missed Monteggia

Introduction The treatment of chronic radial head dislocations after Monteggia lesions in children can be challenging. This article provides a detailed description of the most frequently performed surgical technique: an ulna osteotomy followed by annular ligament reconstruction. Accordingly, we present the clinical and radiological results of 10 paediatric cases. Material and methods All paediatric patients that had a corrective osteotomy of the ulna for a missed Monteggia lesion between 2008 and 2014 were evaluated with standard radiographs and clinical examination. A literature search was performed to identify the relevant pearls and pitfalls of surgery. Primary outcome was range of motion. Results We included 10 patients, with a mean follow-up of 2.5 years. Postoperative range of motion generally improved 30.7°. Even in a patient with obvious deformity of the radial head, range of motion improved after surgery, without residual dislocation of the radial head. Conclusion Corrective proximal ulna osteotomy with rigid plate fixation and annular ligament reconstruction yields good results in patients with chronic radial head dislocation following a Monteggia lesion. Surgery should be considered regardless of patient age or time since trauma. Given substantial arguments in literature, we discourage surgery if a CT scan shows dome-shaped radial head dysmorphic features in work-up to surgery.

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