The study of 60 cases of adult fresh Monteggia fractures / 中华创伤骨科杂志

ABSTRACT

Objective To explore a better treatment of fresh Monteggia fracture and factors which lead to unsatisfactory results. Methods A retrospective study was done on 60 of the 114 patients with Monteggia fractures who had been treated from 1994 to 2004 in our hospital. According to Bado classification, 26 patients were type Ⅰ, 14 type Ⅱ, 19 type Ⅲ, and 1 type Ⅳ. All the cases received operation. Fixation included plates and screws, plates with tension band, with or without plaster to immobilize the limb after operation. For the fracture of the radial head, the radial head was totally or partially removed and fixated with screw or k-wire. Results 60 patients were followed up for an average of 2 years(1 to 6 years). The average score according to the system of Broberg and Morrey was 95 points (53 to 100 points). The result was excellent for 48 patients, good for 6, fair for 4 and poor for 2. Complications included heterotopic ossification, ulnohumeral osteoarthrosis, cross-union, nonunion, radial nerve injury and dysfunction of elbow joint and forearm. Conclusions Yong adults, especial males, tend to suffer this kind of low-energy injury. Anatomic reduction and rigid fixation is the key to satisfactory results. Heterotopic ossification, ulnohumeral osteoarthrosis are the major factors leading to unsatisfactory results.