$monteggia fracture$

The present study aimed to analyze the clinical and radiological results of Monteggia-like lesions in adults with unreconstructible radial head fractures and treatment with radial head replacement.īetween January 2001 and May 2014, all consecutive patients with Monteggia-like lesion and treatment with radial head replacement were included if they met the following inclusion criteria: (1) age ≥ 18 years (2) Monteggia-like lesion with unreconstructible radial head fracture, where anatomical reconstruction of the radial head fracture was not possible (3) treatment with radial head replacement (Evolve, Wright Medical Technology, Arlington, Tennessee) (4) minimum clinical and radiological examination of 2 years (5) written informed consent. In previous studies, the patients treated with radial head replacement for Monteggia-like lesions were grouped with patients with other types of injuries, such as isolated radial head fractures or terrible triad injuries. If the Monteggia-like lesion is accompanied by unreconstructible radial head fractures, prosthetic replacement of the radial head is mostly recommended to prevent proximal migration of the radius. Even though there is a good understanding of the biomechanics of this type of fracture in adults, the rate of complications, revisions, and disappointing functional outcome results are high. Therefore, Monteggia-like lesions in children and adults should be considered separately.

$monteggia fracture$

Reports mostly focus on the treatment and the outcome of Monteggia-like lesions in children, which are distinct from those in adults with regard to the mechanism and patterns of injury. Monteggia-like lesions are severe injuries of the elbow with damage to stabilizing key structures of the elbow, such as the radial head and the coronoid process. The Monteggia-like lesion, a variant of the Monteggia fracture with a fracture of the radial head, is even rarer. The Monteggia fracture can be considered a rare injury, as it accounts for only 2 to 5% of all proximal forearm fractures. Monteggia-like lesions with unreconstructible radial head fracture and treatment with radial head replacement are prone to complications and revisions.Ī Monteggia fracture consists by definition of a fracture of the ulna with ligamentous failure of the proximal radius resulting in dislocation of the radial head. 20 ± 22) and ulnohumeral motion (77° ± 31 vs. Patients with a complicated postoperative course showed a worse clinical outcome compared with patients without complications measured by MEPS (68 ± 22 vs.

$monteggia fracture$

A total of 17 complications were noted in 11 patients (41%), leading to 15 revision surgeries in 9 patients (33%). Heterotopic ossifications were noted in 12 patients (44%). Mean loss of extension was 24° ± 18 and flexion was 124° ± 20. ResultsĪfter a mean follow-up period of 69 months (range, 24 to 170) the mean DASH score was 30 ± 24, the MEPS averaged 77 ± 20 points, the mean VAS R was 2.1 ± 2.4, and VAS P was 4.5 ± 3.5. Complications and revisions were also analyzed. A detailed radiological evaluation was performed. Clinical assessment included the pain level with the visual analog scale in rest (VAS R) and under pressure (VAS P), range of motion, Mayo Elbow Performance Score (MEPS), and Disability of the Arm, Shoulder, and Hand score (DASH).

$monteggia fracture$

Twenty-seven patients (mean age 56 years range 36 to 79 years) with a Monteggia-like lesion and treatment with radial head replacement were included in this retrospective study. The aim of the study was to analyze the functional and radiological outcome of Monteggia-like lesions in adults with unreconstructible fracture of the radial head and treatment with radial head arthroplasty.

$monteggia fracture$