Evidence map›Paper›PMID 39404257›Full record

ArticleActa orthopaedica2024

Bado type III Monteggia fractures have a high injury- and treatment-related complication rate: a single center study of 73 fractures.

Kaj Zilliacus, Yrjänä Nietosvaara, Ilkka Helenius, Niko Kämppä, Ilkka Vuorimies, Petra Grahn

Abstract read
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Article in Acta orthopaedica, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Commentary onJournal of the Pediatric Orthopaedic Society of North America · 2025
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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Kaj ZilliacusDepartment of Pediatric Orthopedics and Traumatology, New Children's Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland. kaj.zilliacus@hus.fi.ORCID 0000-0002-4534-1891
Yrjänä NietosvaaraDepartment of Pediatric Orthopedics and Traumatology, New Children's Hospital, Helsinki University Hospital, University of Helsinki, Helsinki; Department of Pediatric Surgery, Kuopio University Hospital, University of Eastern Finland, Kuopio, Finland.
Ilkka HeleniusDepartment of Orthopedics and Traumatology, HUS Helsinki University Hospital, University of Helsinki, Helsinki, Finland.ORCID 0000-0001-5200-3279
Niko KämppäDepartment of Hand Surgery, HUS Helsinki University Hospital, University of Helsinki, Helsinki, Finland.ORCID 0009-0006-9257-7326
Ilkka VuorimiesDepartment of Radiology, HUS Diagnostic Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Petra GrahnDepartment of Pediatric Orthopedics and Traumatology, New Children's Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.ORCID 0000-0003-3018-8270

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeMonteggia fractures can be problematic injuries. The aim of this population-based study is to evaluate the risk of complications according to the Bado types, clinical outcome, and incidence.

methods72 children (median age 6, range 2-11 years) with 73 Monteggia fractures treated during 2014-2022 were identified from the institutional fracture register. Timing of diagnosis, complications, and method of treatment were registered. Outcomes were assessed at mean 4 years (1-9) follow-up in 68 (94%) children. The census population (< 16 years old) in Helsinki metropolitan area during the study period was assessed.

resultsBado types I (n = 43) and III (n = 27) comprised all but 3 of the fractures. Diagnosis was made on admission in 57, and with a 1-8-day delay in 16 children. 8 children had sustained an associated nerve injury. 35 children were treated operatively, 7 after failed closed treatment. 4 reoperations were performed, including 3 ulnar osteotomies. The risk of complications (odds ratio [OR] 4.9, 95% confidence interval [CI] 1.7-14) and closed treatment failures (OR 12.3, CI 1.3-118) was higher in Bado type III than in type I injuries. 60 children attended for clinical follow-up, all had congruent radio-humeral joints and full range of elbow and forearm motion. Mean PedsQL was 94 (72-100) and QuickDash 3 (0-13). 8 additional children reported normal elbow functions by phone. The calculated mean annual incidence of Monteggia injuries was 2.9/100,000 children.

conclusionMonteggia fractures are rare (2.9/100,000 yearly). Bado type III injuries are associated with a high risk of complications.

Indexed as

Monteggia's FractureChildChild, PreschoolFemaleFinlandFracture Fixation, InternalHumansIncidenceMalePostoperative ComplicationsReoperation

Identifiers

PMID39404257
PMCPMC11474005

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