Missed radial head dislocations in children associated with ulnar deformation: treatment by open reduction and ulnar osteotomy

Abstract

Objective: To evaluate the results of open reduction and ulnar osteotomy on missed Monteggia fractures in children.

Design: Retrospective review.

Setting: Tertiary care center orthopaedic hospital in Pellenberg, Belgium.

Patients/participants: Six children between 2 and 6 years old who sustained a Monteggia fracture that was initially missed were treated at our institute. They presented in our hospital 5 to 59 weeks postinjury.

Intervention: Open reduction of the radial head was performed, combined with a dorsal opening wedge osteotomy of the proximal ulna and fixation with plate and screws.

Main outcome measurements: Mobility of the elbow was measured by an independent observer, evaluating flexion-extension and pronation-supination preoperatively and postoperatively.

Results: All patients regained a normal range of motion, the radial head remained relocated, and the axis of the forearm remained normal.

Conclusion: This operation-open reduction of the radial head and osteotomy of the ulna-results in an excellent outcome for a missed Monteggia fracture in children.