ArticleFrontiers in pediatrics2025
The necessity of ulnar osteotomy in children with missed Monteggia fractures.
Article in Frontiers in pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: The aims of this study were to review our cases of missed Monteggia fracture treated by open reduction of the radial head with or without ulnar osteotomy and to investigate the necessity of ulnar osteotomy in the surgical treatment of a missed Monteggia fracture. Materials and methods: The children were divided into two groups according to the surgical method used. The patients in group A were treated with Kirschner wire or external fixation after ulnar osteotomy and Kirschner wire fixation after open reduction of the humeroradial joint. The patients in group B were treated with open reduction of the humeroradial joint and Kirschner wire fixation and ulnar osteotomy was not performed. The imaging results from the most recent postoperative follow-up were evaluated using the Nakamura grading criteria, and the patients' elbow function was evaluated using the Mayo Elbow Performance Score (MEPS). Results: There were 53 patients in group A and 14 patients in group B. The mean age of the children in group A was older than that in group B and the time to diagnosis and treatment in group A was longer than that in group B. Regarding the Nakamura grading, there was no significant difference in the proportion of those that received an "excellent" postoperative score between group A and group B ( Conclusion: Ulnar osteotomy is not necessary for all children with missed Monteggia fractures. Open reduction of the humeroradial joint followed by Kirschner wire fixation is a surgical option in younger patients with a short time to diagnosis and treatment .
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