Stability-based assessment of Monteggia-type injuries predicts failure of treatment

Paediatric Monteggia-type injuries are complicated by treatment failure and posterior interosseous nerve palsy, without reliable predictive indicators. Outcome is considered to be good, with little patient-reported evidence. We propose novel radiographic parameters. A total of 33 Monteggia-type inju...

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Published inJournal of pediatric orthopaedics. B Vol. 26; no. 1; p. 27
Main Authors Walton, Roger D M, Ormsby, Neal M, Brookes-Fazakerley, Steven D, Manohar, Shambavi, Patel, Trupesh, Wright, David M, Bass, Alf A, Bruce, Colin E
Format Journal Article
LanguageEnglish
Published United States 01.01.2017
Subjects
Child
Child, Preschool
Elbow Joint - injuries
Elbow Joint - surgery
Female
Fracture Fixation, Internal - adverse effects
Fracture Fixation, Internal - methods
Humans
Infant
Male
Monteggia's Fracture - surgery
Radiography
Radius - surgery
Retrospective Studies
Treatment Failure
Treatment Outcome
Ulna Fractures - surgery
Ulnar Neuropathies - etiology
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Summary:Paediatric Monteggia-type injuries are complicated by treatment failure and posterior interosseous nerve palsy, without reliable predictive indicators. Outcome is considered to be good, with little patient-reported evidence. We propose novel radiographic parameters. A total of 33 Monteggia-type injuries were analysed. Posterior interosseous nerve palsy was strongly predicted by the Radial Head Displacement Index. The presence of two or more of three novel instability markers was associated strongly with treatment failure. Patient-reported outcome measures were almost uniformly excellent. We advocate the use of a new, inclusive, stability-based classification of Monteggia-type injuries to predict patients who require accurate internal fixation.
ISSN:1473-5865
DOI:10.1097/BPB.0000000000000355