Angulation osteotomy of ulna for management of missed monteggia fractures and risk factors associated with poor outcomes
Objective: the purpose of this study is to examine the clinical and radiological outcomes, complications and risk factors associated with poor outcomes. Methods: We performed a retrospective chart evaluation in 12 patients (between march 2017–march 2020) who underwent angulation osteotomy of the uln...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-09-01
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| Series: | Journal of Orthopaedic Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2773157X23001686 |
| _version_ | 1797391708880633856 |
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| author | Varun Garg Aditya K S Gowda Anil Regmi Sunny Chaudhary Surabhi Das Bishwa Bandhu Niraula Shivam Bansal Vivek Singh |
| author_facet | Varun Garg Aditya K S Gowda Anil Regmi Sunny Chaudhary Surabhi Das Bishwa Bandhu Niraula Shivam Bansal Vivek Singh |
| author_sort | Varun Garg |
| collection | DOAJ |
| description | Objective: the purpose of this study is to examine the clinical and radiological outcomes, complications and risk factors associated with poor outcomes. Methods: We performed a retrospective chart evaluation in 12 patients (between march 2017–march 2020) who underwent angulation osteotomy of the ulna. Patients were evaluated in terms of demographic data, injury to surgery time interval, instability and radiologic classification given by Bado. The elbows were clinically evaluated using Mayo elbow performance score. Patients were evaluated for complications at last follow-up. Results: There were 12 patients (3 females and 9 males) with mean age at presentation as 8.58 ± 1.93years. According to Bado classification, 9 were type I and 2 were type III and one was type II. In 5 cases additionally radio-capitellar joint was exposed to remove any intervening soft tissue. The mean follow-up was 16.25 ± 1.71 months. At the last follow-up, the mean flexion-extension arc was 114.17° ± 14.43°, mean protonation arc was 64.58°± 9.40°, and supination arc was 69.58°±8.10°. The mean preoperative MEPI score at the last follow-up was 90.83 ± 13.79. Complications such as ulnar prominence at the site of angulation in 2 patients, hypertrophic scar in 2 patients, superficial infection at the surgical site were observed in one patient and re-dislocation in one patient. Conclusion: Ulnar osteotomy is effective procedure for the treatment of missed monteggia fracture. The radio-capitellar joint must be opened to remove any fibrous tissue which may prevent radial head dislocation. Patients age, fracture type, duration of injury and addition of radio-capitellar k-wire is not linked to poor outcomes. Level of evidence: III. |
| first_indexed | 2024-03-08T23:36:41Z |
| format | Article |
| id | doaj.art-4991742860a74631adba37306f8d54b0 |
| institution | Directory Open Access Journal |
| issn | 2773-157X |
| language | English |
| last_indexed | 2024-03-08T23:36:41Z |
| publishDate | 2024-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Orthopaedic Reports |
| spelling | doaj.art-4991742860a74631adba37306f8d54b02023-12-14T05:24:21ZengElsevierJournal of Orthopaedic Reports2773-157X2024-09-0133100296Angulation osteotomy of ulna for management of missed monteggia fractures and risk factors associated with poor outcomesVarun Garg0Aditya K S Gowda1Anil Regmi2Sunny Chaudhary3Surabhi Das4Bishwa Bandhu Niraula5Shivam Bansal6Vivek Singh7Department of Orthopaedics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, 249203, IndiaDepartment of Orthopaedics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, 249203, IndiaDepartment of Orthopaedics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, 249203, IndiaDepartment of Orthopaedics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, 249203, IndiaDepartment of Orthopaedics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, 249203, IndiaDepartment of Orthopaedics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, 249203, IndiaDepartment of Orthopaedics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, 249203, IndiaCorresponding author. Department of Orthopaedics, All India Institute of Medical Sciences, Rishikesh, India.; Department of Orthopaedics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, 249203, IndiaObjective: the purpose of this study is to examine the clinical and radiological outcomes, complications and risk factors associated with poor outcomes. Methods: We performed a retrospective chart evaluation in 12 patients (between march 2017–march 2020) who underwent angulation osteotomy of the ulna. Patients were evaluated in terms of demographic data, injury to surgery time interval, instability and radiologic classification given by Bado. The elbows were clinically evaluated using Mayo elbow performance score. Patients were evaluated for complications at last follow-up. Results: There were 12 patients (3 females and 9 males) with mean age at presentation as 8.58 ± 1.93years. According to Bado classification, 9 were type I and 2 were type III and one was type II. In 5 cases additionally radio-capitellar joint was exposed to remove any intervening soft tissue. The mean follow-up was 16.25 ± 1.71 months. At the last follow-up, the mean flexion-extension arc was 114.17° ± 14.43°, mean protonation arc was 64.58°± 9.40°, and supination arc was 69.58°±8.10°. The mean preoperative MEPI score at the last follow-up was 90.83 ± 13.79. Complications such as ulnar prominence at the site of angulation in 2 patients, hypertrophic scar in 2 patients, superficial infection at the surgical site were observed in one patient and re-dislocation in one patient. Conclusion: Ulnar osteotomy is effective procedure for the treatment of missed monteggia fracture. The radio-capitellar joint must be opened to remove any fibrous tissue which may prevent radial head dislocation. Patients age, fracture type, duration of injury and addition of radio-capitellar k-wire is not linked to poor outcomes. Level of evidence: III.http://www.sciencedirect.com/science/article/pii/S2773157X23001686Monteggia fracturesBado classificationAngulation osteotomyUlnar osteotomyMayo elbow performance score |
| spellingShingle | Varun Garg Aditya K S Gowda Anil Regmi Sunny Chaudhary Surabhi Das Bishwa Bandhu Niraula Shivam Bansal Vivek Singh Angulation osteotomy of ulna for management of missed monteggia fractures and risk factors associated with poor outcomes Journal of Orthopaedic Reports Monteggia fractures Bado classification Angulation osteotomy Ulnar osteotomy Mayo elbow performance score |
| title | Angulation osteotomy of ulna for management of missed monteggia fractures and risk factors associated with poor outcomes |
| title_full | Angulation osteotomy of ulna for management of missed monteggia fractures and risk factors associated with poor outcomes |
| title_fullStr | Angulation osteotomy of ulna for management of missed monteggia fractures and risk factors associated with poor outcomes |
| title_full_unstemmed | Angulation osteotomy of ulna for management of missed monteggia fractures and risk factors associated with poor outcomes |
| title_short | Angulation osteotomy of ulna for management of missed monteggia fractures and risk factors associated with poor outcomes |
| title_sort | angulation osteotomy of ulna for management of missed monteggia fractures and risk factors associated with poor outcomes |
| topic | Monteggia fractures Bado classification Angulation osteotomy Ulnar osteotomy Mayo elbow performance score |
| url | http://www.sciencedirect.com/science/article/pii/S2773157X23001686 |
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