JOCHYMEK, Jiří, Miroslav STRAKA, Jan ŠKVAŘIL and Ladislav PLÁNKA. Řešení následků Monteggiovy zlomeniny v dětském věku (Treatment of Sequelae after Monteggia Lesions in Childhood). Acta chirurgiae orthopaedicae et traumatologiae čechoslovaca. Praha: Galén, 2012, vol. 79, No 1, p. 48-51. ISSN 0001-5415.
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Basic information
Original name Řešení následků Monteggiovy zlomeniny v dětském věku
Name (in English) Treatment of Sequelae after Monteggia Lesions in Childhood
Authors JOCHYMEK, Jiří (203 Czech Republic, guarantor, belonging to the institution), Miroslav STRAKA (203 Czech Republic), Jan ŠKVAŘIL (203 Czech Republic, belonging to the institution) and Ladislav PLÁNKA (203 Czech Republic, belonging to the institution).
Edition Acta chirurgiae orthopaedicae et traumatologiae čechoslovaca, Praha, Galén, 2012, 0001-5415.
Other information
Original language Czech
Type of outcome Article in a journal
Field of Study 30211 Orthopaedics
Country of publisher Czech Republic
Confidentiality degree is not subject to a state or trade secret
Impact factor Impact factor: 1.628 in 2009
RIV identification code RIV/00216224:14110/12:00063913
Organization unit Faculty of Medicine
UT WoS 000301392400007
Keywords in English Monteggia fracture; consequences; reconstruction surgery; childhood
Tags International impact, Reviewed
Changed by Changed by: Ing. Mgr. Věra Pospíšilíková, učo 9005. Changed: 19. 2. 2013 16:32.
Abstract
Ačkoliv Monteggiova léze nepatří v dětské traumatologii k častým poraněním, následky neléčené či špatně léčené léze mohou přinést pacientovi vážné problémy. Ty ve větčině případů spočívají ventrální luxaci hlavičky rádia, popřípadě dochází k subluxaci hlavičky rádia při rotačních pohybech. Často progreduje valgozita lokte, omezení rotačních pohybů předloktí a tento stav je často spojen s bolesti při pohybu, později i v klidu.
Abstract (in English)
PURPOSE OF THE STUDY To review the current methods of operative management of post-traumatic chronic radial head dislocation in chronic Monteggia lesions in children. MATERIAL AND METHODS Post-traumatic chronic dislocation of the proximal radius usually occurs following missed or ineffectively treated Monteggia fractures. The radial head is usually dislocated anteriorly. We performed open reduction of the radial head, reconstruction of the annular ligament and corrective osteotomy of the ulna in eleven patients. Three of our patients underwent ulnar lengthening via gradual distraction using an Ilizarov external fixator. This procedure was used in nine boys and five girls who were treated for complications following Monteggia lesions between 2000 and 2009. The average age at the time of surgery was 8 years and 4 months, the average injury-to-surgery interval was 19 months, and a prerequisite for surgery was a normal concave articular surface of the proximal radius. The patients were followed up for an average of 28 months and, at final follow-up, all were fully active and had no pain or instability. RESULTS The complications included: non-union of the ulnar osteotomy site in two patients, residual radiocapitellar subluxation in two patients, and one patient had revision surgery. Nine patients showed a full range of motion, two had a loss of extension, and three had a mean loss of pronation of 20 degrees and a mean loss of supination of 20 degrees. DISCUSSION The Monteggia lesion is a rare fracture in childhood, but its sequelae can be serious. So far a unified therapeutic approach has not been proposed. Most authors prefer reconstruction surgery. Our results are in full agreement with the published data. CONCLUSIONS The operative treatment of consequences after Monteggia fractures in children has a relatively high rate of complications and unpredictable results. Indications for reconstruction involve a normal articular surface of the radial head and a normal alignment of the radius and ulna.
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