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Acute Monteggia lesions in children
The Journal of Bone and Joint Surgery. American Volume
|January 1, 1977
Summary
This study treated 25 pediatric Monteggia fractures using closed reduction, a common method for these elbow injuries. Excellent outcomes were achieved in all patients, highlighting effective treatment strategies for pediatric fractures.
Area of Science:
- Pediatric Orthopedics
- Pediatric Trauma Surgery
Background:
- Monteggia fractures are complex elbow injuries in children.
- Type-II Monteggia lesions are rare in pediatric populations.
- Effective management is crucial for optimal long-term outcomes.
Purpose of the Study:
- To report on the treatment and outcomes of consecutive acute Monteggia lesions in children.
- To document a rare case of Type-II Monteggia lesion in a pediatric patient.
- To evaluate the efficacy of closed reduction and adjunct fixation techniques.
Main Methods:
- Retrospective review of 25 consecutive pediatric Monteggia lesions treated over six years.
- Primary treatment involved closed reduction.
- Percutaneous Kirschner wire fixation was used in two cases to stabilize the radial head after reduction.
Main Results:
- All 25 patients, except one, were successfully treated with closed reduction.
- A rare Type-II Monteggia lesion was successfully managed.
- Two patients received percutaneous Kirschner wire fixation for radial head stability.
- All cases demonstrated excellent functional outcomes at an average 34-month follow-up.
Conclusions:
- Closed reduction is an effective primary treatment for acute Monteggia lesions in children.
- Percutaneous Kirschner wire fixation can be a useful adjunct for managing unstable radial heads.
- Pediatric Monteggia fractures, including rare variants, can achieve excellent results with appropriate management.