Surgical Treatment of Monteggia-Like Lesions With a Modified Boyd Approach
Introduction Monteggia-like lesions are rare injuries in adults that include a wide spectrum of complex fracture-dislocations of the proximal ulna and radius. In this retrospective study, we performed a modified Boyd approach and a standard surgical protocol for the treatment of these lesions. Our a...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2023-08-01
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| Series: | Journal of Shoulder and Elbow Arthroplasty |
| Online Access: | https://doi.org/10.1177/24715492231196622 |
| _version_ | 1797736778061316096 |
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| author | Zinon T. Kokkalis , MD, PhD Aikaterini Bavelou , MD Dimitrios Kalavrytinos , MD, MsC George Sinos , MD Panagiotis Antzoulas , MD, MsC Andreas Panagopoulos , MD, PhD |
| author_facet | Zinon T. Kokkalis , MD, PhD Aikaterini Bavelou , MD Dimitrios Kalavrytinos , MD, MsC George Sinos , MD Panagiotis Antzoulas , MD, MsC Andreas Panagopoulos , MD, PhD |
| author_sort | Zinon T. Kokkalis , MD, PhD |
| collection | DOAJ |
| description | Introduction Monteggia-like lesions are rare injuries in adults that include a wide spectrum of complex fracture-dislocations of the proximal ulna and radius. In this retrospective study, we performed a modified Boyd approach and a standard surgical protocol for the treatment of these lesions. Our aim was to evaluate the results of the operative treatment for patients with Monteggia-like lesions, using a modified Boyd approach. Materials and Methods We present a retrospective study of 14 patients who underwent surgical treatment for Monteggia-like lesions. Preoperative clinical and radiological evaluation was performed. In 5 cases radial head prosthesis was placed, and in 3 cases the radial fracture was stabilized with the use of interfragmental screws. Regarding the proximal ulnar fracture, ORIF-anatomical plate and ORIF-straight plate was used in 12 and 2 cases, respectively. Results Average clinical follow up was 16.9 months. Postoperatively, the mean Mayo Elbow Performance score was 83.4 points (range 70-100) and the mean visual analog scale was 1.7 (range 0-14). Mean flexion and loss of extension were 122.1° (range 80°-140°) and 21.4° (range 5°-40°), respectively. Mean supination of the forearm was 66.8° (range 50°-80°) and the mean pronation was 67.5° (range 60°-75°). Heterotopic ossification was observed in 3 patients (21.4%) and 1 patient developed stiffness (7.1%). The patient who developed stiffness underwent reoperation for plate removal and arthrolysis, with satisfactory results. Conclusions The surgical treatment of Monteggia-like lesions in adults remains a challenge. In the present study, the use of a standard surgical protocol, with a modified Boyd approach, successfully restores the movement and stability of the elbow, with a low complication rate. |
| first_indexed | 2024-03-12T13:18:52Z |
| format | Article |
| id | doaj.art-cbc5d5a40b314a97b774c72ab53c79c1 |
| institution | Directory Open Access Journal |
| issn | 2471-5492 |
| language | English |
| last_indexed | 2024-03-12T13:18:52Z |
| publishDate | 2023-08-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Shoulder and Elbow Arthroplasty |
| spelling | doaj.art-cbc5d5a40b314a97b774c72ab53c79c12023-08-26T08:39:26ZengSAGE PublishingJournal of Shoulder and Elbow Arthroplasty2471-54922023-08-01710.1177/24715492231196622Surgical Treatment of Monteggia-Like Lesions With a Modified Boyd ApproachZinon T. Kokkalis , MD, PhD0Aikaterini Bavelou , MD1Dimitrios Kalavrytinos , MD, MsC2George Sinos , MD3Panagiotis Antzoulas , MD, MsC4Andreas Panagopoulos , MD, PhD5 Department of Orthopaedics, School of Medicine, , Patras, Greece Department of Orthopaedics, School of Medicine, , Patras, Greece 251 Air Force General Hospital, Athens, Greece Department of Orthopaedics, School of Medicine, , Patras, Greece Department of Orthopaedics, School of Medicine, , Patras, Greece Department of Orthopaedics, School of Medicine, , Patras, GreeceIntroduction Monteggia-like lesions are rare injuries in adults that include a wide spectrum of complex fracture-dislocations of the proximal ulna and radius. In this retrospective study, we performed a modified Boyd approach and a standard surgical protocol for the treatment of these lesions. Our aim was to evaluate the results of the operative treatment for patients with Monteggia-like lesions, using a modified Boyd approach. Materials and Methods We present a retrospective study of 14 patients who underwent surgical treatment for Monteggia-like lesions. Preoperative clinical and radiological evaluation was performed. In 5 cases radial head prosthesis was placed, and in 3 cases the radial fracture was stabilized with the use of interfragmental screws. Regarding the proximal ulnar fracture, ORIF-anatomical plate and ORIF-straight plate was used in 12 and 2 cases, respectively. Results Average clinical follow up was 16.9 months. Postoperatively, the mean Mayo Elbow Performance score was 83.4 points (range 70-100) and the mean visual analog scale was 1.7 (range 0-14). Mean flexion and loss of extension were 122.1° (range 80°-140°) and 21.4° (range 5°-40°), respectively. Mean supination of the forearm was 66.8° (range 50°-80°) and the mean pronation was 67.5° (range 60°-75°). Heterotopic ossification was observed in 3 patients (21.4%) and 1 patient developed stiffness (7.1%). The patient who developed stiffness underwent reoperation for plate removal and arthrolysis, with satisfactory results. Conclusions The surgical treatment of Monteggia-like lesions in adults remains a challenge. In the present study, the use of a standard surgical protocol, with a modified Boyd approach, successfully restores the movement and stability of the elbow, with a low complication rate.https://doi.org/10.1177/24715492231196622 |
| spellingShingle | Zinon T. Kokkalis , MD, PhD Aikaterini Bavelou , MD Dimitrios Kalavrytinos , MD, MsC George Sinos , MD Panagiotis Antzoulas , MD, MsC Andreas Panagopoulos , MD, PhD Surgical Treatment of Monteggia-Like Lesions With a Modified Boyd Approach Journal of Shoulder and Elbow Arthroplasty |
| title | Surgical Treatment of Monteggia-Like Lesions With a Modified Boyd Approach |
| title_full | Surgical Treatment of Monteggia-Like Lesions With a Modified Boyd Approach |
| title_fullStr | Surgical Treatment of Monteggia-Like Lesions With a Modified Boyd Approach |
| title_full_unstemmed | Surgical Treatment of Monteggia-Like Lesions With a Modified Boyd Approach |
| title_short | Surgical Treatment of Monteggia-Like Lesions With a Modified Boyd Approach |
| title_sort | surgical treatment of monteggia like lesions with a modified boyd approach |
| url | https://doi.org/10.1177/24715492231196622 |
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