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Monteggia lesions in adults. A multicenter Bota study
P Reynders1, W De Groote, J Rondia
1Department of Traumatology and Emergency Surgery, University Hospitals K. U. Leuven, Belgium.
Acta Orthopaedica Belgica
|January 1, 1996
Summary
Monteggia fractures in adults often yield poor outcomes, with nearly half experiencing fair or poor results. Improved surgical techniques, like dorsal plating and avoiding early radial head resection, are recommended to enhance healing and function.
Area of Science:
- Orthopedic Surgery
- Traumatology
Background:
- Monteggia fractures are complex injuries involving the proximal ulna and radial head.
- Outcomes for adult Monteggia fractures treated surgically are variable.
Purpose of the Study:
- To evaluate the long-term outcomes of surgically treated adult Monteggia fractures.
- To identify factors influencing treatment success and complications.
Main Methods:
- Retrospective review of 67 adult Monteggia lesions.
- Analysis of treatment outcomes (good/excellent vs. fair/poor) over 1-14 years.
- Correlation of outcomes with fracture types (Bado's classification) and associated injuries.
Main Results:
- 53.7% of patients achieved good to excellent results; 46.3% had fair or poor outcomes.
- Complications occurred in 43% of cases, including delayed healing and persistent radial head dislocation.
- Better outcomes were associated with Bado types I and III; poorer outcomes with types II and IV.
- Fractures involving the olecranon, particularly type Ia, had worse results.
Conclusions:
- Surgical treatment of adult Monteggia fractures has a high complication rate and suboptimal outcomes.
- Recommendations for improved results include dorsal plating of ulnar fractures, avoiding early radial head resection, and early elbow mobilization.