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. 2022 Nov 22;7(6):2612-2616.
doi: 10.1016/j.jseint.2022.10.011. eCollection 2023 Nov.

Radial head volume measurements using quantitative three-dimensional computed tomography images for radial head deformation following missed Monteggia lesions

Lisette C Langenberg  1   2   3 , Stein J Janssen  4 , Denise Eygendaal  1   3
Affiliations

Radial head volume measurements using quantitative three-dimensional computed tomography images for radial head deformation following missed Monteggia lesions

Lisette C Langenberg et al. JSES Int. .

Abstract

Background: In chronic radial head dislocation cases, the radial head may enlarge and become dome-shaped. To date, there is no validated tool to quantify radial head deformation and predict its influence on surgical outcomes. This study assesses the potential value of volume and surface calculations obtained by quantitative three-dimensional computed tomography scanning (Q3DCT) in the workup for a corrective surgery in pediatric patients with missed Monteggia lesions.

Material and methods: Ten consecutive pediatric patients with a missed Monteggia lesion were included (2012-2020). The volume and articular surface size of the radial head were calculated using Q3DCT, and a three-dimensional reconstruction of the articular surface relief was depicted in a heat map. The head-neck ratio was calculated and compared to Q3DCT data of missed Monteggia patients and their age-/sex-matched controls.

Results: The radial head volume and radial articular surface size did not differ significantly between patients with missed Monteggia lesions and age-/sex-matched controls (volume 1487 mm3 vs. 1163 mm3, P = .32; articular surface size 282 mm3 vs. 236 mm3, P = .33). Optically, heat maps of the articular surface of missed Monteggia patients did not differ notably from control heat maps. A higher head-neck ratio correlated to a larger radial head volume (Pearson r = 0.73; P = .2).

Discussion and conclusion: Q3DCT may be an interesting tool in the preoperative workup of pediatric missed Monteggia lesions. Prospective research with larger cohort sizes and data that compares the affected side to the contralateral elbow is needed to assess its true clinical potential.

Keywords: Corrective elbow surgery; Missed Monteggia; Pediatric Monteggia; Radial head dislocation; Radial head dysplasia; Three-dimensional CT analysis.

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Figures

Figure 1
Figure 1
Heat map image of the radial head articular surface relief (case 4). (A) Missed Monteggia patient; (B) age-/sex-matched control.
See this image and copyright information in PMC

References

    1. Belangero W.D., Livani B., Zogaib R.K. Treatment of chronic radial head dislocations in children. Int Orthop. 2007;31:151–154. doi: 10.1007/s00264-006-0153-4. - DOI - PMC - PubMed
    1. Chauhan P. Surgical treatment in children missed Monteggia lesions at Bhuj , Kutch , Gujarat : a retrospective study. Int J Res Orthop. 2017;3:30–34. doi: 10.18203/issn.2455-4510.IntJResOrthop20164411. - DOI
    1. Datta T., Chatterjee N.D., Pal A.K., Das S.K. Evaluation of outcome of corrective ulnar osteotomy with bone grafting and annular ligament reconstruction in neglected Monteggia fracture dislocation in children. J Clin Diagn Res. 2014;8:1–4. doi: 10.7860/JCDR/2014/9891.4409. - DOI - PMC - PubMed
    1. Degreef I., De Smet L. Missed radial head dislocations in children associated with ulnar deformation: treatment by open reduction and ulnar osteotomy. J Orthop Trauma. 2004;18:375–378. doi: 10.1097/00005131-200407000-00008. - DOI - PubMed
    1. Delpont M., Jouve J.L., Sales de Gauzy J., Louahem D., Vialle R., Bollini G., et al. Proximal ulnar osteotomy in the treatment of neglected childhood Monteggia lesion. Orthop Traumatol Surg Res. 2014;100:803–807. doi: 10.1016/j.otsr.2014.06.022. - DOI - PubMed

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