Monteggia fracture in children

Monteggia lesion (ML) is a complex and rare injury in children that requires expert diagnosis and treatment. Failure to recognize or insufficiently diagnose this condition can be catastrophic for the child in terms of upper-limb motor function. The aim of this study is to analyze retrospective data of patients with ML treated at the Department of Pediatric Surgery, Comenius University and National Institute of Children's Diseases in Bratislava between 2010 and 2020, and to evaluate treatment outcomes.

A retrospective analysis of 131 patients with ML was performed and categorized according to the timing of management: acute (within 24 hours), subacute (after 24 hours), and chronic (after more than 3 weeks). Treatment outcomes were evaluated using the Anderson scoring system. For statistical analysis, non-parametric methods were used: the Wilcoxon paired test to compare pre- and postoperative changes, and the Kruskal-Wallis test to assess differences among the three groups.

Out of the 131 patients, 95 were diagnosed with ML (72.5%) and 36 with Monteggia equivalent lesions (EML; 27.5%). In the acute group, 63 patients received treatment with excellent outcomes. Patients with EML achieved satisfactory results, but with a higher rate of surgical intervention. Among chronic ML cases, functional outcomes improved in 13 out of 15 patients (86.6%).

Rapid and accurate diagnosis and treatment of ML are essential to prevent complications and to ensure optimal outcomes. Chronic ML often leads to poorer results, underscoring the importance of early recognition and prevention.