title: Proximal ulnar osteotomy in the treatment of neglected childhood Monteggia lesion.
abstract: BACKGROUND
  The aim of our study was to analyze medium and long-term results of proximal ulnar osteotomy with and without ligament injury in neglected Monteggia injury in children.
  
  
  METHODS
  This retrospective, multicenter study included 28 patients. Clinical criteria concerned the range of motion, pain and MEPI score, and radiologic criteria comprised of Storen line, head-neck ratio, radial neck angle, and signs of osteoarthritic remodeling.
  
  
  RESULTS
  Twenty-eight patients were reviewed, at a mean 6 years' follow-up (range, 2-34y). Sixteen had proximal ulnar osteotomy without ligament reconstruction, and 12 had associated ligamentoplasty. Both groups showed significant clinical and radiological improvement, with no significant difference. Patients operated within less than 1 year had better clinical and radiographic results. There was no correlation between age at surgery and quality of results. The 5 patients who underwent condyloradial pinning showed early recurrence of dislocation and osteoarthritic remodeling. The three cases of Bado type-3 lesion had early recurrence of dislocation.
  
  
  CONCLUSIONS
  Proximal ulnar osteotomy gives good long-term results in Bado type-1 lesions, regardless of age, if performed before 1 year, in the absence of osteoarthritic remodeling. Associated ligamentoplasty does not seem to be useful.
  
  
  METHODS
  IV (retrospective).
authors.affiliation: Service d'orthopédie infantile, hôpital Trousseau, 26, avenue Netter, 75012 Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Delpont
authors.affiliation: Service d'orthopédie infantile, hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille, France.
authors.forename: J-L
authors.initials: JL
authors.lastname: Jouve
authors.affiliation: Service d'orthopédie infantile, hôpital des Enfants, 30, avenue de Grande-Bretagne - TSA 70034, 31059 Toulouse cedex 9, France.
authors.forename: J
authors.initials: J
authors.lastname: Sales de Gauzy
authors.affiliation: Service d'orthopédie infantile, hôpital Lapeyronie, 371, avenue du Doyen Gaston-Giraud, 34295 Montpellier, France.
authors.forename: D
authors.initials: D
authors.lastname: Louahem
authors.affiliation: Service d'orthopédie infantile, hôpital Trousseau, 26, avenue Netter, 75012 Paris, France.
authors.forename: R
authors.initials: R
authors.lastname: Vialle
authors.affiliation: Service d'orthopédie infantile, hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille, France.
authors.forename: G
authors.initials: G
authors.lastname: Bollini
authors.affiliation: Service d'orthopédie infantile, hôpital des Enfants, 30, avenue de Grande-Bretagne - TSA 70034, 31059 Toulouse cedex 9, France.
authors.forename: F
authors.initials: F
authors.lastname: Accadbled
authors.affiliation: Service d'orthopédie infantile, hôpital Lapeyronie, 371, avenue du Doyen Gaston-Giraud, 34295 Montpellier, France. Electronic address: jerome.cottalorda@gmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Cottalorda
mesh_terms: D002648:Child; D002649:Child Abuse; D002675:Child, Preschool; D004551:Elbow Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D009011:Monteggia's Fracture / Q000000981:diagnostic imaging / Q000601:surgery*; D010027:Osteotomy / Q000379:methods*; D011859:Radiography; D016059:Range of Motion, Articular; D012008:Recurrence; D012189:Retrospective Studies; D013997:Time Factors; D014457:Ulna / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*
keywords: Children; Monteggia; Radial head dislocation; Ulnar osteotomy