[The results of treatment in pediatric Monteggia equivalent lesions].
OBJECTIVE
We evaluated the results of conservative and surgical treatment of pediatric Monteggia equivalent lesions.


METHODS
The study included 13 children (3 females, 10 males; mean age 8 years; range 4 to 13 years) who underwent treatment for Monteggia equivalent lesions. Seven patients (53.9%) had Bado type 1 and six patients (46.2%) had type 3 equivalent lesions. Two patients with type 3 equivalent lesions also had a lateral humeral condyle fracture. On presentation, one patient (7.7%) had radial nerve palsy. Primarily, closed reduction was attempted in all the patients except for one patient who underwent urgent debridement and irrigation for an open fracture-dislocation. Reduction was successful in eight patients (61.5%). Upon failure of closed reduction, four patients (30.8%) underwent surgery within the first 24 hours of injury. Functional assessment was made according to the Reckling's criteria. The mean follow-up period was 4.1 years (range 2 to 7 years).


RESULTS
None of the patients had nonunion. Conservative treatment did not result in loss of reduction of the radius head or limitation in the range of motion of the elbow joint. Except for the patient with an open fracture-dislocation leading to a poor functional result, the results were good in all the patients receiving conservative or surgical treatment. One patient (7.7%) treated conservatively developed cubitus varus (5 degrees ) and posterior angulation (20 degrees ) of the ulnar fracture line. One patient treated surgically had limitation of supination (10 degrees ) without limitation of flexion or extension of the elbow joint. Accompanying radial nerve palsy in this patient disappeared in the postoperative third month.


CONCLUSIONS
Closed reduction is the first choice of treatment in pediatric Monteggia equivalent lesions. Surgical treatment becomes necessary if closed reduction fails.
Department of Orthopedics and Traumatology (Ortopedi ve Travmatoloji Anabilim Dali), Medicine Faculty of Abant Izzet Baysal University, Bolu, Turkey. maguven2000@gmail.com
Melih
M
Güven
Abdullah
A
Eren
Bariş
B
Kadioğlu
Umut
U
Yavuz
Volkan
V
Kilinçoğlu
Korhan
K
Ozkan
D002648:Child; D002675:Child, Preschool; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D017102:Fracture Healing / Q000502:physiology; D006801:Humans; D004204:Joint Dislocations / Q000601:surgery; D008297:Male; D009011:Monteggia's Fracture / Q000601:surgery*; D017060:Patient Satisfaction; D011885:Radius Fractures / Q000601:surgery*; D016059:Range of Motion, Articular / Q000502:physiology*; D012086:Reoperation; D016896:Treatment Outcome