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KMID : 0361620090440040473
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Journal of the Korean Orthopaedic Association
2009 Volume.44 No. 4 p.473 ~ p.479
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Treatment of Neglected Monteggia Fracture-Dislocation in Children
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Shim Jong-Sup
Seo Sung-Wook
Ahn Jong-Ho
Kim Sang-Min
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Abstract
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Purpose :Our purpose is to evaluate the results of the operative treatment in neglected Monteggia fracture-dislocation in children.
Materials and Methods :We retrospectively analyzed 10 elbows in 10 patients who underwent surgery. All patients were classified as Bado type I, except one with type III. The mean duration of follow up was 2 years and 5 months. The mean age at the time of operation was 10 years and the mean time from injury to operation was 7 months. All 10 patients underwent open reduction of the radial head and reconstruction of annular ligament. Ulnar osteotomy was performed in 9 cases. Clinical assessment was done by Bruce et al.’s rating system.
Results :All 10 patients gained a mean of 35° of extension-flexion arc, however lost a mean of 29° of pronation-supination arc. And there were three complications, including dislocation of radial head in two patients and breakage of transarticular K-wire in one patient. According to Bruce et al.’s rating system, there were 4 excellent, 1 good, 3 fair, and 2 poor results.
Conclusion :We found that the effect of the operative treatment of neglected Monteggia fracturedislocation in children was limited in majority of the patients. Particularly, the loss of pronation-supination arc was noticed postoperatively in most patients.
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KEYWORD
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Monteggia fracture-dislocation, Surgery, Functional result
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