Long-Term Clinical and Radiographic Outcomes After Open Reduction for Missed Monteggia Fracture-Dislocations in Children

2009 ◽  
Vol 91 (6) ◽  
pp. 1394-1404 ◽  
Author(s):  
Koichi Nakamura ◽  
Kazuhiko Hirachi ◽  
Shigeharu Uchiyama ◽  
Masatoshi Takahara ◽  
Akio Minami ◽  
...  
Keyword(s):  
Open Reduction ◽  
Monteggia Fracture ◽  
Radiographic Outcomes ◽  
Fracture Dislocations ◽  
Missed Monteggia

Fractures and Fracture Dislocations of the Midfoot: Occurrence, Causes and Long-term Results

2001 ◽  
Vol 22 (5) ◽  
pp. 392-398 ◽  
Author(s):  
Martinus Richter ◽  
Burkhard Wippermann ◽  
Christian Krettek ◽  
Hanns Eberhard Schratt ◽  
Tobias Hufner ◽  
...  
Keyword(s):  
Open Reduction ◽  
Traffic Accidents ◽  
Fracture Dislocation ◽  
Long Term Results ◽  
Treatment Optimization ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Fracture Dislocations

Etiology and outcome of 155 patients with midfoot fractures between 1972 and 1997 were analyzed to create a basis for treatment optimization. Cause of injuries were traffic accidents (72.2%), falls (11.6%), blunt injuries (7.7%) and others (5.8%). Isolated midfoot fractures (I) were found in 55 (35.5%) cases, Lisfranc fracture dislocations (L) in 49 (31.2%), Chopart-Lisfranc fracture dislocations (CL) in 26 (16.8%) and Chopart fracture dislocations (C) in 25 (16%). One hundred and forty eight (95%) of the midfoot fractures were treated operatively; 30 with closed reduction, 115 with open reduction, 3 patients had a primary amputation. Seven (5%) patients were treated non-operatively. Ninety seven (63%) patients had follow-up at an average of 9 (1.3–25, median 8.5) years. The average scores of the entire follow-up group were as follows: AOFAS – sum of all four sections (AOFAS-ET): 296, AOFAS-Midfoot (AOFAS-M): 71, Hannover Scoring System (HSS): 65, and Hannover Questionnaire (Q): 63. Regarding age, gender, cause, time from injury to treatment and method of treatment no score differences were noted (t-test: p > 0.05). L, C or I showed similar scores and CL significantly lower scores (AOFAS-ET, AOFAS-M, HSS, Q). The highest scores in all groups were achieved in those fractures treated with early open reduction and operative fixation. Midfoot fractures, particularly fracture dislocation injuries, effect the function of the entire foot in the long-term outcome. But even in these complex injuries, an early anatomic (open) reduction and stable (internal) fixation can minimize the percentage of long-term impairment.

Proximal and Palmar Dislocation of the Lunate and Proximal Scaphoid as a Unit in a Case of Scaphocapitate Syndrome

1998 ◽  
Vol 23 (2) ◽  
pp. 266-268 ◽  
Author(s):  
R. PANDIT
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Functional Result ◽  
Fracture Dislocation ◽  
Long Term Results ◽  
Proximal Pole ◽  
Fracture Dislocations ◽  
Perilunate Fracture Dislocation ◽  
Palmar Aspect

Various patterns of transscaphoid, transcapitate fracture-dislocations have been described in the literature. There is little information on the method of management and the long-term results of such severe and rare injuries. The case described here involved a transscaphoid, transcapitate, palmar perilunate fracture-dislocation with ejection of the proximal pole of the scaphoid and lunate into the palmar aspect of the forearm. The functional result 32 months after delayed open reduction and internal fixation is reported.

scholarly journals Clinical outcome of acute Monteggia fractures in children after open reduction and internal fixation of ulna

2021 ◽  
Author(s):  
Manoj Kumar ◽  
Muhammad Farooq Bhatt ◽  
Sanjeev Gupta ◽  
Zubair A. Lone ◽  
Maneer Ahmed ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Internal Fixation ◽  
Open Reduction ◽  
Monteggia Fracture ◽  
Medical College ◽  
Fractures In Children ◽  
Fracture Dislocations ◽  
Ulna Fractures ◽  
Study Participants ◽  
Type 3

Background: Monteggia fracture dislocations are a rare but a complex injury. The fracture of the ulna associated with proximal radioulnar joint dissociation and radio capitellar dislocation. This injury comprises less than 1% of all pediatric forearm fractures and typically affects patients between 4 and 10 years of age. There are many options for treatment of these fractures. The present study was planned to assess the clinical outcome of patients treated with open reduction and internal fixation of ulna with plating.Methods: The study was conducted in department of orthopedics, government medical college and hospital, Jammu from August 2018 to January 2021. 25 patients of Monteggia fractures were managed with open reduction and internal fixation of ulna with plating. Patients were evaluated at follow-up for pain, stability and disturbance of daily and sports activities. Functional outcome was assessed using elbow performance score.Results: Mean age of study participants was 8.2 years and male children predominated our study constituting 17 patients (68%). 14 patients were Bado type 1, four patients were Bado type 2 whereas seven patients were Bado type 3. The outcome was excellent in 18 patients (72%) and no cases of failure were encountered.Conclusions: Stable anatomical fixation by open reduction and internal fixation of ulna fractures with plating, that in turns leads to the stable reduction of radial head, in the management of acute Monteggia fracture dislocations in children has a very good outcome.

scholarly journals Long-term outcome after ulnar osteotomy for missed Monteggia fracture dislocation in children

2011 ◽  
Vol 5 (6) ◽  
pp. 449-457 ◽  
Author(s):  
Ole Rahbek ◽  
Søren Rasmussen Deutch ◽  
Søren Kold ◽  
Jens Ole Søjbjerg ◽  
Bjarne Møller-Madsen
Keyword(s):  
Fracture Dislocation ◽  
Monteggia Fracture ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Ulnar Osteotomy ◽  
Monteggia Fracture Dislocation ◽  
Missed Monteggia

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.

scholarly journals A New Pediatric Monteggia Fracture Type 4 Variant

2021 ◽  
Vol 11 (10) ◽  
Author(s):  
Ehab S Saleh
Keyword(s):  
Open Reduction ◽  
Fracture Dislocation ◽  
Monteggia Fracture ◽  
Radial Head Dislocation ◽  
Proximal Ulna ◽  
Joint Dislocation ◽  
Ulna Fracture ◽  
Joint Dislocations ◽  
Fracture Dislocations ◽  
Monteggia Fracture Dislocation

Introduction: Monteggia fracture-dislocations are rare and complex injuries that usually involve a fracture of the proximal ulna associated with a proximal radioulnar and radiocapitellar joint dislocations. These injuries comprise <1% of all pediatric forearm fractures. We report on a pediatric Monteggia fracture-dislocation variant that included an irreducible divergent ulnohumeral joint dislocation, an irreducible anterior radial head dislocation, and a proximal and distal radius and ulna fracture. Case Report: A 6-year-old female came to our emergency room with a right elbow and forearm pain and deformity after a fall from a slide on the same day. X-rays revealed a divergent ulnohumeral joint dislocation, an anterior radiocapitellar joint dislocation, a proximal radioulnar joint dislocation, and a proximal and distal ulna and radius fracture. Closed reduction under sedation in the emergency room was not successful, with persistent ulnohumeral, ulnoradial, and radiocapitellar joint dislocations. The patient was taken to the operating room the next morning. She underwent open reduction and internal fixation of the proximal ulna fracture with a one-third tubular locking plate, and radial head dislocation open reduction. A stable reduction of the ulnohumeral joint was only possible after the fixation of the proximal ulna fracture. The most stable position for the radiocapitellar joint after its open reduction was at 70o of elbow extension and full forearm supination; the patient was casted in that position for 6 weeks. Conclusion: Pediatric Monteggia fracture-dislocations are rare and complex childhood fractures, and new variants of this injury can have even more complex presentations. Open reduction and stable internal fixation addressing all components of this injury will lead to an excellent outcome. Keywords: Pediatric monteggia fracture-dislocation, new type four variant, divergent ulnohumeral joint dislocation, irreducible dislocation.

scholarly journals Impact of Open Reduction on Surgical Strategies for Missed Monteggia Fracture in Children

2017 ◽  
Vol 58 (4) ◽  
pp. 829 ◽  
Author(s):  
Hoon Park ◽  
Kwang-Won Park ◽  
Kun Bo Park ◽  
Hyun Woo Kim ◽  
Nam Kyu Eom ◽  
...  
Keyword(s):  
Open Reduction ◽  
Monteggia Fracture ◽  
Surgical Strategies ◽  
Missed Monteggia

Traumatic Luxation of the Elbow in 31 Dogs

1999 ◽  
Vol 12 (01) ◽  
pp. 33-39 ◽  
Author(s):  
P. Wolvekamp ◽  
B.P. Meij ◽  
L.F.H. Theijse ◽  
H. A. W. Hazewinkel ◽  
I.G.F. Schaeffer
Keyword(s):  
Medical Records ◽  
Closed Reduction ◽  
Elbow Joint ◽  
Open Reduction ◽  
Clinical Results ◽  
Monteggia Fracture ◽  
Ligament Repair ◽  
Elbow Luxation ◽  
Methods Of Treatment

SummaryThe medical records of 31 dogs with traumatic luxation of the elbow joint were reviewed. The patients were referred to the Faculty of Veterinary Medicine of the Utrecht University during the period from 1984 to 1996. Nineteen dogs with an acute lateral luxation were treated by closed reduction. One dog with an acute bilateral luxation and two dogs with chronic elbow luxation were treated by open reduction. In four dogs the collateral ligaments were sutured on one side following closed reduction and in one dog following open reduction.Five dogs had a Monteggia fracture. One was treated by closed reduction and external coaptation and 4 by open reduction with osteosynthesis. Excellent or good results were achieved in eight of the 19 dogs (47%) treated by closed reduction, in 1 of 3 (33%) treated by open reduction and in three of five (60%) treated for a Monteggia fracture. The quite disappointing results of the closed reduction appeared to be largely due to the instability remaining after the reduction in seven of the 19 elbow joints (41%).Collateral ligament repair was performed in three dogs immediately following closed reduction and the clinical result was excellent in all three. When the elbow joint is unstable after reduction of a traumatic luxation, it should be stabilized surgically.Traumatic cubital luxation is an emergency which occurs infrequently in dogs. The methods of treatment used in 31 dogs are reviewed and the long-term clinical results are evaluated. Good results can be expected for acute closed reduction, provided that stability is improved surgically if the elbow is unstable after reduction. Monteggia fractures should always be treated by open reduction.

Clinical, functional and radiographic outcomes after revision total hip arthroplasty with tapered fluted modular or non-modular stems: a systematic review

2021 ◽  
pp. 112070002110043
Author(s):  
Antonios A Koutalos ◽  
Sokratis Varitimidis ◽  
Konstantinos N Malizos ◽  
Theofilos Karachalios
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Revision Rate ◽  
Clinical Results ◽  
Fracture Rate ◽  
Revision Total Hip Arthroplasty ◽  
Term Survival ◽  
Total Hip ◽  
Radiographic Outcomes

Purpose: The aim of the study was to systematically evaluate clinical outcomes of tapered fluted stems, either monoblock or modular, in revision total hip arthroplasty. Methods: PubMed, EMBASE and Web of Science and Cochrane databases were systematically searched by 2 researchers. Clinical studies reporting primarily on survival and re-revision rates, and secondarily on subsidence, dislocation, intraoperative fractures, periprosthetic fractures and infection were included. 2 investigators assessed the quality of the studies. Results: 46 studies were included in this review, reporting on 4601 stem revisions. The pooled re-revision rate was 5.1% and long-term survival ranged from 75% to 98.5%. No differences were observed between monoblock and modular stems regarding re-revision rate, dislocation rate, periprosthetic fracture rate or infection rates. Monoblock stems exhibited more subsidence and modular stems displayed more intraoperative fractures. Conclusions: Satisfactory results can be obtained with the use of tapered fluted end-bearing stems. Monoblock stems offer the same clinical results as modular stems.

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