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Published on: August 15, 2019
Neglected Monteggio lesion--is full recovery expected?
Kiran Kumar Mukhopadhyay1, Sanjay Kumar, Bijoy Bhattacharjya
1Department of Orthopaedics, NRS Medical College, Kolkata 700014.
Journal of the Indian Medical Association
|June 22, 2013
Summary
This study treated chronic Monteggia lesions using ulna osteotomy and ligament repair. The procedure showed promising outcomes for neglected fractures, improving function and reducing pain.
Area of Science:
- Orthopedic surgery
- Traumatology
- Upper extremity reconstruction
Background:
- Chronic (neglected) Monteggia fractures present significant challenges in adult upper extremity reconstruction.
- Delayed treatment can lead to persistent deformity, pain, and functional deficits.
Purpose of the Study:
- To evaluate the efficacy of angulation distraction osteotomy of the ulna combined with annular ligament reconstruction for chronic Monteggia lesions.
- To assess functional outcomes, pain reduction, and range of motion following surgical intervention.
Main Methods:
- Retrospective analysis of eleven patients with chronic Monteggia lesions (injury > 6 months).
- Surgical treatment involved angulation distraction osteotomy of the ulna and reconstruction of the annular ligament.
- Patients were followed up for an average of 56 months, with assessments including deformity, pain, function, and range of motion.
Main Results:
- All eleven patients underwent the described surgical procedure.
- Mean follow-up was 56 months.
- Terminal restriction of at least 15 degrees pronation was observed in all cases post-operatively.
Conclusions:
- Angulation distraction osteotomy of the ulna and annular ligament reconstruction can be a viable treatment option for chronic Monteggia lesions.
- While functional improvements are expected, residual pronation deficits may persist.
- Further research with larger cohorts is warranted to optimize outcomes.
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