title: [Treatment of Monteggia fracture in children].
abstract: Described in this paper is a therapeutic concept by which to cope with Monteggia's fracture in childhood. It is based on experience obtained from 72 cases with injuries of that kind and their evaluation in a group study. Therapeutic approach to the individual case was determined by the following criteria: age of infant, localisation and shape of ulnar fracture, reducibility of capitulum radii, and accompanying injuries requiring treatment on the same arm. The need for surgical stabilisation of ulnar fracture was found to increase along with growing age of the affected child. High-stability anatomic reduction of the ulnar fracture proved to be a prerequisite for safe stabilisation of the radial capitulum. Close reduction has proved to be sufficient in many instances. Open reduction and internal fixation were found to be necessary in cases in which an ulnar fracture was irreducible or instable and/or a radial head was not reducible. Minimal osteosynthesis and plaster cast is considered to be an optional therapy for younger children, whereas ulnar stabilisation by means of plates is preferred for children in somewhat advanced age of childhood. The radial head may be fixed by trans-articular Kirschner's wire (WITT) or primary reconstruction of the annular ligament, using a strip of biceps or triceps tendon, or adaptation around the collum radii and ulna of the proximal radio-ulnar joint by means of a sling of Dexon or Vicryl suture.
authors.affiliation: Arbeitsgemeinschaft für Traumatologie des Kindesalters, Lübben.
authors.forename: H
authors.initials: H
authors.lastname: Vinz
authors.forename: R
authors.initials: R
authors.lastname: Franz
authors.forename: W
authors.initials: W
authors.lastname: Kurz
authors.forename: P
authors.initials: P
authors.lastname: Mehnert
authors.forename: D
authors.initials: D
authors.lastname: Wahl
mesh_terms: D002648:Child; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D009011:Monteggia's Fracture / Q000000981:diagnostic imaging / Q000601:surgery*; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011859:Radiography; D000092464:Elbow Injuries
vernacular_title: Die Behandlung der Monteggia-Fraktur beim Kind.