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Acute monteggia fractures in children
1Department of Orthopedics and Traumatology, Veterans General Hospital-Taipei, Taiwan, R.O.C.
Zhonghua Yi Xue Za Zhi = Chinese Medical Journal; Free China Ed
|November 1, 1996
Summary
Nonsurgical management of acute Monteggia fractures in children, primarily type I, yielded excellent functional results with closed reduction and casting. All fractures united without deformity or dislocation, demonstrating effective nonoperative treatment.
Area of Science:
- Pediatric Orthopedics
- Traumatology
Background:
- Monteggia fractures are rare in children.
- Type I Monteggia fractures are the most common presentation in pediatric cases.
Purpose of the Study:
- To evaluate the functional outcomes of non-surgical management for acute Monteggia fractures in children.
- To assess the efficacy of closed reduction and long arm casting in pediatric Monteggia fractures.
Main Methods:
- A retrospective review of 15 pediatric Monteggia fracture cases treated between July 1988 and October 1994.
- All patients underwent closed reduction and immobilization with long arm casting in a supinated forearm and flexed elbow position.
- Fracture types included predominantly type I (73.3%), with types III and IV also represented.
Main Results:
- All 15 fractures achieved union without residual ulna deformity or radial head dislocation after an average follow-up of 45.9 months.
- Excellent functional outcomes were reported for all patients.
- One case of pre-treatment posterior interosseous nerve palsy resolved spontaneously.
Conclusions:
- Nonsurgical management, specifically closed reduction with long arm casting, is highly effective for acute Monteggia fractures in children.
- Pediatric Monteggia fractures demonstrate superior outcomes with nonoperative treatment compared to adult cases.
- This approach ensures union and excellent function, making it a reliable treatment strategy.