title: Open reduction and annular ligament reconstruction with fascia of the forearm in chronic monteggia lesions in children.
abstract: Fifteen children with chronic Monteggia lesions were treated with open reduction, annular ligament reconstruction with fascia of the forearm, and ulnar osteotomy. Mean age was 8 years 3 months (range 3-16 years). The chronicity of missed Monteggia was from 6 weeks to 2 years (mean 12 weeks). All patients were classified as Bado type I, except one with Bado type III. Mean follow-up was 4 years 3 months after surgery. There was a loss of pronation in six cases with the mean of 16 degrees. However, only four cases had rotational loss; the others had a mean rotational arch increase of 5 degrees. The flexion arches improved in all patients, with a mean of 27.7 degrees. The functional result was excellent in 11 patients, good in 3 patients, and poor in 1 patient. This one-incision approach is safe in treating chronic Monteggia lesions in children.
authors.affiliation: Department of Orthopaedic Surgery, National University Hospital, Singapore.
authors.forename: James H P
authors.initials: JH
authors.lastname: Hui
authors.forename: Abdul R
authors.initials: AR
authors.lastname: Sulaiman
authors.forename: Haw-Chou
authors.initials: HC
authors.lastname: Lee
authors.forename: Khee-Sien
authors.initials: KS
authors.lastname: Lam
authors.forename: Eng-Hin
authors.initials: EH
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D001858:Bone Nails; D001864:Bone Wires; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D017885:Collateral Ligaments / Q000601:surgery*; D000071938:Fasciotomy; D005260:Female; D005500:Follow-Up Studies; D005542:Forearm; D006801:Humans; D008297:Male; D009011:Monteggia's Fracture / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D010027:Osteotomy / Q000295:instrumentation; D011859:Radiography; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome