Does overcorrection cause any negative effect on pediatric missed Monteggia lesion?

Area of Science:

• Orthopedic surgery
• Pediatric orthopedics
• Traumatology

Background:

• Missed Monteggia fracture is a complex injury in children.
• Ulna osteotomy is a key surgical step for anatomical reduction.
• Different correction techniques may influence outcomes.

Purpose of the Study:

• To compare clinical and radiological outcomes of anatomical versus overcorrection ulna osteotomy in missed Monteggia fractures.
• To investigate the association between correction degree and postoperative complications.

Main Methods:

• Retrospective review of 21 patients with type 1 missed Monteggia fracture.
• Patients divided into anatomical correction (Group 1) and overcorrection (Group 2, ≥10° dorsal angulation) groups.
• Clinical outcomes assessed by Kim elbow performance score; radiological outcomes by radial head reduction status.

Main Results:

• Overcorrection group showed significantly higher rates of fair-to-poor radiological outcomes (40% vs. 0%, p=0.035).
• Clinical outcomes were also less favorable in the overcorrection group (20% vs. 0%, p=0.214).
• Two cases of posterior radial head dislocation occurred in the overcorrection group post-surgery.

Conclusions:

• Anatomical correction ulna osteotomy demonstrates superior radiological outcomes compared to overcorrection.
• Overcorrection techniques in ulna osteotomy may increase the risk of radial head posterior dislocation.