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초록
Purpose:
Most of the patients who have acute Monteggia fracture require surgical treatment. Open reduction and res-toration of the alignment for the ulna, and early reduction of the radial head are the principles of treatment. The authors performed anatomic reduction and plate fixation of the ulna in acute Monteggia fractures and the aim of this study is to report the radiological and clinical results of the management.
Methods:
Medical records and imaging data of 13 patients who had only internal fixation of the ulna in acute Monteggia fracture were reviewed retrospectively. The mean age was 38.8 years and average follow-up period was 23.9 months. We evaluated the range of motion, Mayo elbow performance score (MEPS), Disabilities of the Arm, Shoulder and Hand (DASH) score and complications at the last follow-up. Bone union and reduction of the radial head were reviewed by as-sessing serial radiographs during the follow-up.
Results:
Bone union was obtained in all cases and radial heads were maintained their reduced position on the follow-up radiographs. The mean MEPS was 91.15 and the mean DASH score was 7.9 at the last follow-up. The mean elbow flexion was 136.5°, elbow extension was 1.2°, forearm pronation was 79°, and forearm supination was 71°. There was no specific complication during the follow-up and 3 patients had secondary surgery for plate removal by patients’’ request.
REFERENCES
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Fig. 1.
A 35-year-old female with Bado type I Monteggia fracture of the right forearm after pedestrian traffic accident. (A) Preoperative radiologic finding shows type I Monteggia fracture. X-ray shows anterior dislocation of radial head and angulation of ulnar metaphysical fracture. Postoperative X-ray finding showed good alignment of ulna and radial head reduction. (B) At the final follow-up, and the range of motion was 5° to 140°, and satisfactory results were obtained.
Fig. 2.
A 30-year-old female with Bado type III Monteggia fracture of the right forearm after slip and fall injury. (A) Preoperative radiologic finding shows type III Monteggia fracture. X-ray shows lateral dislocation of radial head and posterior angulation of ulnar metaphysical fracture. In this case, using olecranon plate ulna and radial head reduction was done. (B) There was no pain at the final follow-up, and the range of motion was 0° to 150° and satisfactory results were obtained.
Table 1.
Demographic data
Table 2.
Summary of results
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