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J Pediatr Orthop B 2019 Feb 15. Epub 2019 Feb 15.

Department of Pediatric Orthopedics and Traumatology, Istituto Ortopedico Rizzoli, Via Pupilli, Bologna, Italy.

The treatment of a missed Monteggia (MM) fracture dislocation is still controversial. We describe our initial experience with ulnar osteotomy and progressive correction with unilateral external fixator in MM. We retrospectively evaluated 20 children undergoing ulnar osteotomy and progressive distraction angulation by unilateral external fixator to treat MM. Read More

Chin J Traumatol 2018 Dec 30. Epub 2018 Dec 30.

Department of Orthopaedics & Traumatology, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia.

Simultaneous ipsilateral fractures involving radial head and distal end of radius are uncommon. We present our thoughts on which fracture should be addressed first. A 68-year-old lady sustained an ipsilateral fracture of the right radial head and distal end of radius following a fall. Read More

Orthop Surg 2019 Feb 4;11(1):102-108. Epub 2019 Feb 4.

Department of Pediatric Orthopaedics, The Third Hospital of Hebei Medical University, Shijiazhuang, China.

Objective: The treatment of missed Monteggia fracture remains a challenge, despite the various surgical methods described. The purpose of this study was to explore a new surgical technique utilizing external fixator-assisted ulnar osteotomy and to assess the surgical results in a case series.

Methods: Thirteen patients with missed Monteggia fractures were treated at our institution using this new surgical technique from August 2012 to January 2016. Read More

Medicine (Baltimore) 2019 Jan;98(2):e13942

Department of Pediatric Surgery.

Various methods are applied in the treatment of fresh and neglected Monteggia fractures. The purpose of this retrospective study was to evaluate the efficacy of various treatment methods, and assess the complexity associated with missed radial head dislocation.All fracture patients were reviewed between Jan 2012 and Dec 2016. Read More

Medicine (Baltimore) 2019 Jan;98(1):e13978

Department of Orthopaedic Surgery, Nippon Medical School, Tokyo, Japan.

Treatment of chronic Monteggia fracture-dislocations remains controversial in skeletally immature patients. The present study aimed to review the clinical outcomes of surgical treatment with an Ilizarov mini-fixator for chronic Monteggia fracture-dislocations in children. From April 2003 to March 2014, 5 pediatric patients (4 males, 1 female) with chronic Monteggia fracture-dislocation were treated with an Ilizarov mini-fixator at our institution. Read More

Orthop Traumatol Surg Res 2019 Feb 24;105(1S):S75-S87. Epub 2018 Dec 24.

Chirurgie orthopédique et traumatologique, CHU Charles-Nicolle, 1, rue de Germont, 76031 Rouen, France.

The appropriate management of early treatment failures in patients with elbow injuries requires the identification of the cause of failure. In this work, six types of elbow injury are considered: (i) identification of early failed reduction of a dislocation or fracture-dislocation of the elbow should lead to a repeat reduction procedure, testing for elbow instability, and ligament repair, followed by the use of a hinged external fixator to allow early mobilisation. Differentiating an isolated dislocation from a dislocation combined with a fracture of the coracoid process is crucial. Read More

Acta Chir Orthop Traumatol Cech 2018 ;85(2):102-108

Department of Orthopaedic Surgery, The Affiliated Wujin Hospital of Jiangsu University, Changzhou, China.

PURPOSE OF THE STUDY This study aims to analyze the clinical and radiographic outcomes of a consecutive series of 18 patients with terrible triad injury. The coronoid fractures of these patients were repaired using Mother-Child screw (MCS). MATERIAL AND METHODS Twelve men and six women (mean age: 47. Read More

J Shoulder Elbow Surg 2018 Nov 14;27(11):e337-e343. Epub 2018 Sep 14.

Department of Orthopedic Surgery, University Hospitals Leuven, Pellenberg, Belgium.

Background: Pediatric Monteggia fractures are relatively rare and are commonly missed. Radial head subluxation can persist with long-term consequences if these fractures are left untreated. We evaluated the long-term treatment outcomes after open reduction with ulnar osteotomy for missed Monteggia fractures during childhood. Read More

J Am Acad Orthop Surg Glob Res Rev 2018 May 3;2(5):e035. Epub 2018 May 3.

Department of Orthopedic Surgery, Shiroyama Hospital, Habikino, Japan (Dr. Abe, Dr. Kumano, and Dr. Kinoshita), and the Department of Orthopedic Surgery, Osaka Medical College, Takatsuki, Japan (Dr. Hirofuji).

Background: In pediatric patients with Monteggia lesions, the radial head can be reduced manually when displacement of the fractured ulna is corrected. Occasionally, however, a dislocated radial head could not be reduced manually even when the length and/or angulation of the fractured ulna had been corrected. We can find such cases in the literature, but those are single case reports. Read More

Pan Afr Med J 2018 18;29:216. Epub 2018 Apr 18.

Department of Orthopaedic Surgery, University Hospital, Monastir 5000, Tunisia.

Monteggia described a fracture of the proximal third of the ulna with anterior dislocation of the radial head from both the proximal radioulnar and radiocapitellar joints. The key treatment principle in Monteggia fractures is stable anatomic alignment of the ulna. We present an uncommon case of a Monteggia fracture-dislocation with an unreducable anterior dislocation of the radial head and associated with a lesion of the lateral collateral ligament of the elbow. Read More

World J Orthop 2018 Jul 18;9(7):100-104. Epub 2018 Jul 18.

Department of Orthopaedic Surgery and Traumatology, Habib Bourguiba University Hospital, Sfax 3000, Tunisia.

Anterior transolecranon dislocation of the elbow is rarely observed in children, reported in only a small series. The present case involves an anterior transolecranon dislocation of the left elbow joint in a 7-year-old child, which was surgically treated. Two attempts of closed reduction failed because the radial head had buttonholed via the joint capsule. Read More

Bone Joint J 2018 08;100-B(8):1117-1124

Department of Orthopedic Surgery, Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Aims: Delayed diagnosis is a well-known complication of a Monteggia fracture-dislocation. If left untreated, the dislocated radial head later becomes symptomatic. The purposes of this study were firstly, to evaluate the clinical and radiological results of open reduction of the radial head and secondly, to identify the factors that may affect the outcome of this procedure. Read More

J Med Case Rep 2018 Jul 18;12(1):211. Epub 2018 Jul 18.

Hospital Sultan Ismail, Jalan Persiaran Mutiara Emas, Tmn Mount Austin, 81100, Johor Bahru, Malaysia.

Background: Blunt trauma causing brachial artery injury in a young patient is very rare. Cases of brachial artery injury may be associated with closed elbow dislocation or instability. Elbow dislocation may not be evident clinically and radiologically on initial presentation. Read More

Open Orthop J 2018 31;12:189-195. Epub 2018 May 31.

Department of orthopaedics, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India.

Introduction: Dislocation of the radial head in adults is quite uncommon. A simultaneous dislocation of the radial head with a fracture of ipsilateral shaft radius without any other associated injury is even rare.

Case Presentation: We are reporting a case of a young adult male who was operated for proximal one-third radial shaft fracture at some peripheral centre by Open Reduction and Internal Fixation (ORIF), but came to our centre on the fourth post-operative day with complaints of painful restricted movements of the elbow joint. Read More

J Pediatr Orthop B 2019 Jan;28(1):67-72

Department of Orthopedic Surgery and Traumatology, Faculty of Medicine, Alexandria University, Alexandria, Egypt.

Bony exostoses are benign osteocartilaginous growths that start close to growth plates. Approximately 30-60% of patients have forearm deformities. The commonly encountered forearm deformities in these patients are bowing of the radius, with or without ulnar drift of the carpus, radial head dislocation, shortening of the ulna, and radial head dislocation. Read More

Tech Hand Up Extrem Surg 2018 Sep;22(3):81-88

Leni & Peter W. May Department of Orthopaedic Surgery, Mount Sinai Hospital, New York, NY.

Essex-Lopresti Lesions are rare injuries that are often missed in the acute setting. Delayed intervention may lead to chronic wrist and elbow pain and overall poor outcomes. The literature currently supports treatments that involve shortening of the ulna to reduce the relative degree of ulnar impaction, followed by attempted reduction of the distal radioulnar joint. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2017 Dec;31(12):1409-1413

Department of Orthopedics, the First Hospital of Jilin University, Changchun Jilin, 130021,

Objective: To observe the effectiveness of reduction and fixation by the improved elbow anteromedial approach in treatment of ulna coronoid process fracture.

Methods: Between January 2010 and December 2014, 13 patients with the ulna coronoid process fracture were treated with reduction and fixation by the improved elbow anteromedial approach. There were 10 males and 3 females with an average age of 37. Read More

Unfallchirurg 2019 Mar;122(3):219-224

Chirurgische Universitätsklinik und Poliklinik, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil, Bochum, Deutschland.

Background: Radial head fractures are the most frequent fractures of the elbow joint in adults. For Mason type II fractures without concomitant injuries favorable results have been shown with operative and conservative management. There is insufficient evidence concerning elbow joint stability after conservative treatment compared to open reduction and internal fixation (ORIF). Read More

BMJ Case Rep 2018 Mar 28;2018. Epub 2018 Mar 28.

Department of Surgery, Sint Antonius Ziekenhuis, Utrecht, The Netherlands.

A 10-year-old girl presented to the emergency department with proximal radioulnar translocation and radial head fracture, after fall onto an outstretched hand. Open reduction was used to reduce and stabilise the elbow joint after which the radial head was fixated by Kirschner wires. Three months after surgery, full range of motion was regained and union of the radial head was achieved. Read More

Medicine (Baltimore) 2017 Nov;96(47):e8609

Department of Pediatric Orthopedics, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.

Open reduction combined with ulnar osteotomy is the most common approach to treating missed Monteggia injuries. The osteotomy is usually performed at the proximal ulna to ensure better healing and fewer complications. The purpose of this study is to present a center of rotation angulation (CORA)-based osteotomy of the ulna for treating Bado type I Monteggia injuries. Read More

Int J Surg 2018 Mar 3;51:49-55. Epub 2018 Feb 3.

Department of Orthopaedics Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, NO.109, Xue Yuan West Road, Wenzhou, Zhejiang Province, 325000, China. Electronic address:

Introduction: Dislocation of the elbow associated with radial head and coronoid fracture, the so-called "terrible triad" of the elbow, is challenging to treat and has a history of complicated outcomes. This study is to compare the clinical outcome of a single lateral approach-the extensile splitting extensor digitorum communis (EDC) approach and combined lateral and medial (CML) approaches for the treatment of terrible traid of the elbow (TTE).

Material And Methods: After appropriate exclusion, 60 TTE patients (28 patients in the EDC group, 32 patients in the CML group) from 2009 January to 2015 August were reviewed in this study. Read More

Open Orthop J 2017 30;11:1394-1404. Epub 2017 Nov 30.

Coventry and Warwickshire Shoulder and Elbow Unit, University Hospitals Coventry & Warwickshire NHS Trust, Clifford Bridge Road, Coventry, CV2 2DX, UK.

Background: The elbow is the second most commonly dislocated joint in adults and up to 20% of dislocations are associated with a fracture. These injuries can be categorised into groups according to their mechanism and the structures injured.

Methods: This review includes a literature search of the current evidence and personal experiences of the authors in managing these injuries. Read More

Clin Orthop Surg 2017 Dec 10;9(4):521-528. Epub 2017 Nov 10.

Department of Orthopaedic Surgery and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.

Background: Various deformities can occur in the forearm bones when the traumatically dislocated radial head is untreated for a long period. Without correction of all deformities, reduction of the dislocated radial head is difficult to maintain, and forearm and elbow motion will deteriorate after reduction. We evaluated radiographic parameters of forearms with traumatically dislocated radial heads (and of the normal sides) to understand the resulting deformities and the effectiveness of surgical treatment. Read More

Hand (N Y) 2019 Mar 29;14(2):249-252. Epub 2017 Nov 29.

1 Maimonides Medical Center, Brooklyn, NY, USA.

Background: Fractures of the radial shaft with disruption of the distal radial ulnar joint (DRUJ) or Galeazzi fractures are treated with reduction of the radius followed by stability assessment of the DRUJ. In rare instances, the reduction of the DRUJ is blocked by interposed structures requiring open reduction of this joint. The purpose of this study is to review all cases of irreducible Galeazzi fracture-dislocations reported in the literature to offer guidelines in the diagnosis and management of this rare injury. Read More

Orthop Traumatol Surg Res 2018 Feb 22;104(1S):S113-S120. Epub 2017 Nov 22.

Service de chirurgie pédiatrique, hôpital Lapeyronie, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 5, France.

The Monteggia injury is defined as radial head dislocation with a fracture of the ulnar shaft. This combination should be sought routinely in patients with ulnar fractures, even when the displacement is small. The emergent management is simple, as reducing the ulnar fracture is usually sufficient to stabilise the radial head. Read More

Hand Clin 2018 02;34(1):75-83

Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 20114, USA. Electronic address:

The treatment goals of elbow fracture dislocations are congruent reduction of the ulnohumeral and radiocapitellar joints, stable fixation of the proximal ulna, stable fixation or arthroplasty of the radial head, and soft tissue repair. Fracture dislocations occur in patterns, and recognition of these patterns help guide surgical treatment. In patients with persistently unstable fractures after standard fixation, additional temporary joint spanning implants are useful to protect repairs. Read More

Skeletal Radiol 2018 Mar 2;47(3):397-400. Epub 2017 Oct 2.

Trauma Center, Ben Arous, Tunisia.

The Essex-Lopresti injury is an extremely rare condition combining radial head or neck fracture, distal radio-ulnar joint dislocation and rupture of the interosseous membrane. However, there are rare or unusual varieties or associated injuries. We report a case of a 46-year-old woman with a posterior dislocation of the radio-humeral joint, a radial shaft fracture, and a distal radio-ulnar joint dislocation. Read More

J Hand Surg Am 2018 01 27;43(1):85.e1-85.e6. Epub 2017 Sep 27.

Department of Orthopaedics, University of Maryland, Baltimore, MD. Electronic address:

Purpose: The purposes of this study were to identify the relative frequency of Monteggia fracture patterns and to investigate the required frequency of open reduction of the proximal radiocapitellar joint.

Methods: We identified 121 Monteggia fractures at a Level I trauma center from 1996 to 2015 and included 119 in this study. These fractures were identified using a database search for the appropriate International Classification of Diseases, Ninth Revision and Current Procedural Terminology codes as well as individual surgeons' logs. Read More

Acta Chir Orthop Traumatol Cech 2017 ;84(3):182-188

Klinika úrazové chirurgie Masarykovy nemocnice v Ústí nad Labem a Univerzity J.E. Purkyně, Ústí nad Labem.

PURPOSE OF THE STUDY The study aims to evaluate and compare the results of conservative and operative treatment of individual types of distal ulna fractures associated with distal radius fracture treated by plate osteosynthesis and to verify the conclusions of the other authors regarding the recommended therapeutic procedures in these fractures. MATERIAL AND METHODS In the period from 08/2013 to 09/2015, a total of 81 patients participated in the prospective randomised study, with the mean follow-up period of 24 months (6-36). All the fractures of distal two thirds of ulnar styloid process were treated conservatively. Read More

Cochrane Database Syst Rev 2017 07 28;7:CD007759. Epub 2017 Jul 28.

Department of General Practice, Erasmus Medical Center, PO Box 2040, Rotterdam, Netherlands, 3000 CA.

Background: Pulled elbow (nursemaid's elbow) is a common injury in young children. It often results from a sudden pull on the arm, usually by an adult or taller person, which pulls the radius through the annular ligament, resulting in subluxation (partial dislocation) of the radial head. It can also be caused by a fall or twist. Read More

J Shoulder Elbow Surg 2017 Aug;26(8):1342-1347

Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran. Electronic address:

Background: Terrible triad (TT) is one of the severe injuries of the elbow that generally requires surgery. Nonsurgical treatment has recently been applied in selected cases of TT injury. Evaluation of the results of this treatment was the main aim of this study. Read More

Open Orthop J 2017 31;11:263-267. Epub 2017 Mar 31.

Department of Orthopedics, Bahrain Defence Force Hospital - Royal Medical Services, Kingdom of Bahrain.

Background: Various types of osteotomies have been used to facilitate reduction of the radial head and to prevent recurrent subluxation. The Bouyala technique - open reduction of radial head associated with open wedge ulnar osteotomy with or without annular ligament reconstruction, is presently the most widely used treatment for long- standing traumatic dislocation of the radial head, independently of age, in the absence of osteoarthritis remodeling, and should preferably be performed within 1 year of trauma.

Method: In this article, we present a similar case operated by same technique, but we used synthetic phosphocalcic ceramic wedge graft instead of auto bone graft as described in many other studies. Read More

Yonsei Med J 2017 Jul;58(4):829-836

Division of Orthopedic Surgery, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea.

Purpose: The aims of this study were to review our cases of missed Monteggia fracture treated by open reduction of the radial head with or without ulnar osteotomy and to investigate the indications for open reduction alone in surgical treatment of missed Monteggia fracture.

Materials And Methods: We retrospectively reviewed 22 patients who presented with missed Monteggia fracture. The patients' mean age at the time of surgery was 7. Read More

J Pediatr Orthop 2017 Sep;37(6):e335-e341

*Department of Orthopaedic Surgery, University of California †Department of Orthopedics, Rady Children's Hospital and Health Center, San Diego, CA.

Background: In 2015, a multicenter study group proposed a treatment algorithm for pediatric Monteggia fractures based upon the ulnar fracture pattern. This strategy recommends surgical stabilization for all complete ulna fractures. The purpose of this study was to evaluate whether an initial nonoperative approach to pediatric Monteggia fractures resulted in poorer outcomes and a higher rate of complications. Read More

Eur J Orthop Surg Traumatol 2017 Jul 7;27(5):599-605. Epub 2017 Apr 7.

Department of Trauma and Orthopaedics, Northern General Hospital, Herries Road, Sheffield, S5 7AU, UK.

Purpose: Monteggia variant defined as Monteggia fracture dislocation with radial head or neck fracture, coronoid fracture, ulnohumeral joint dislocation or combination of these injuries. The aim of this study was to evaluate clinical outcomes of surgical treatment of Monteggia variant fracture dislocations with focus on the operative technique and management of associated radial head fractures.

Methods: Between January 2008 and January 2014, 22 patients (7 men, 15 women) with a mean age of 58. Read More

Oper Orthop Traumatol 2017 Apr 17;29(2):125-137. Epub 2017 Mar 17.

Klinik für Orthopädie und Unfallchirurgie, Luzerner Kantonsspital, 6000, Luzern, Schweiz.

Aim Of Surgery: Reconstruction of the most important ligamentous and osseus structures of the elbow after terrible triad injury via the radial head to the lateral collateral ligament complex (LCL) and if necessary beginning at the coronoid process. The aim is a stable concentrically guided elbow with early functional follow-up treatment. The approach depends on the intraoperatively tested stability. Read More

Medicine (Baltimore) 2017 Mar;96(11):e6377

Department of Orthopedics, The First Affiliated Hospital of Jinan University, Guangzhou, China.

Rationale: Elbow injury in children by improper treatment or a delay of more than 3 weeks could lead to old unreduced Monteggia fracture, which are difficult to manage. Conservative or normal surgical methods usually fail.

Patient Concerns: Herein, we present a 6-year-old boy with sustaining injury approximately 1 month to his left elbow. Read More

J Pediatr Orthop B 2018 Mar;27(2):142-146

Department of Orthopaedics, Shriners Hospital for Children, Philadelphia, Pennsylvania, USA.

Delayed diagnosis of a Monteggia fracture-dislocation changes a straightforward, treatable injury into a complex problem. Acute neonatal injuries may be missed because of the inability to visualize the unossified skeleton on radiography, interpreted later as 'congenital' dislocations. We report the case of a 14-month-old with a neonatal Monteggia type-I fracture-dislocation secondary to birth trauma, with anterior radial head dislocation and plastic deformation of the ulna. Read More

Ortop Traumatol Rehabil 2016 Oct;18(5):435-444

Department of Traumatology and Orthopaedics, MND CRH Military Institute of Medicine in Warsaw, Poland.

Background: Appropriate treatment of radial head fractures remains an area of disputes and controversy. The present paper aims to assess the outcomes of surgical fixation of these injuries and identify the most common complications.

Material And Methods: The medical records of 63 patients (25 women and 38 men) treated in 2011 -2014 were analysed retrospectively. Read More

BMJ Case Rep 2016 Dec 30;2016. Epub 2016 Dec 30.

Galway University Hospitals, Galway, Galway, Ireland.

Posterolateral dislocation of the elbow is an injury commonly treated in the emergency department by closed reduction. Very rarely it can be irreducible and require open reduction. Only four cases of irreducible posterolateral elbow dislocation have been described in the literature over the past 50 years. Read More

Trauma Mon 2016 Jul 15;21(3):e20686. Epub 2016 May 15.

Orthopaedics and Trauma Department, Ozel Antalya Memorial Hospital, Antalya, Turkey.

Introduction: The debate regarding the description on classification and nomenclature of the injury which includes olecranon fracture associated with radial neck fractures in children is ongoing. We report two pediatric cases that could not be classified in a Monteggia-equivalents system and were treated with open reduction and k-wire fixation. The aim of this study was to perform a systematic review regarding pediatric radial neck fractures associated with olecranon fractures and presentation of two pediatric cases of olecranon fractures associated with radial neck fractures with radiocapitellar dislocation. Read More

J Pediatr Orthop B 2017 Jan;26(1):36-40

aDepartment of Orthopaedics, Tulane School of MedicinebDepartment of Orthopaedics, Children's Hospital, New Orleans, Louisiana, USA.

Monteggia fractures comprise a small subset of fractures in the pediatric population that are normally reduced nonoperatively. Complex Monteggia fractures can be more difficult to identify and require operative intervention. We describe a case of a Bado type I Monteggia fracture with a posteriorly dislocated radial head and neck fracture that has not been described before in the literature. Read More

Am J Emerg Med 2017 Jan 2;35(1):159-163. Epub 2016 Nov 2.

Department of Orthopaedic Surgery, Sports Medicine Service, Massachusetts General Hospital, 175 Cambridge Street, Boston, MA 02114, USA. Electronic address:

Background/aim: Nursemaid's elbow usually occurs in young children when longitudinal traction is placed on the arm. Several manipulative maneuvers have been described, although, the most effective treatment technique is yet unclear. The aim of this systematic review and meta-analysis was to compare the two most commonly performed maneuvers (supination-flexion and hyperpronation) in the treatment of nursemaid's elbow. Read More

Ann R Coll Surg Engl 2016 Nov 22;98(8):e165-e167. Epub 2016 Sep 22.

Countess of Chester Hospital NHS Foundation Trust, Chester, and The Royal Manchester Children's Hospital , Manchester , UK.

Radial head dislocations are common in children who fall onto outstretched hands. We present a case of medial radial head dislocation without a concomitant ulna fracture in a 14-year-old girl and the long-term sequelae of the injury. Read More

J Clin Diagn Res 2016 Aug 1;10(8):RD01-3. Epub 2016 Aug 1.

Professor, Department of Orthopaedics, Sree Lakshmi Narayana Institute of Medical Sciences , Pondicherry, India .

Monteggia fracture constitutes about 5-10% of the forearm fractures. Monteggia fracture by definition is proximal ulnar fracture with disruption of proximal radioulnar joint. Bado classified Monteggia fracture dislocation into four types and Jupiter subclassified type II Bado's fractures into four types. Read More

Int J Surg Case Rep 2016 26;27:102-106. Epub 2016 Aug 26.

Department of Orthopaedics and Traumatology, Acıbadem Maslak Hospital, İstanbul, Turkey.

Introduction: The main goal of the treatment is the anatomical reduction of the ulna fracture and the radial head dislocation in acute and chronic Monteggia cases. Acute pediatric Monteggia lesions are generally treated non-surgically; however, the treatment of chronic Monteggia is challenging. The aim of this article is to share our experiences about treatment of neglected Monteggia lesion. Read More

J Orthop Sci 2016 Nov 9;21(6):759-765. Epub 2016 Aug 9.

Department of Hand Surgery, Graduate School of Medicine, Nagoya University, Nagoya, Japan.

Background: To evaluate the mid- to long-term clinical and radiographic outcomes after surgical treatment of chronic anterior dislocation of the radial head in children.

Methods: Open reduction was performed in 16 children (mean age, 9.3 years [range, 2. Read More

Skeletal Radiol 2016 Oct 8;45(10):1449-52. Epub 2016 Aug 8.

Department of Orthopedic Surgery, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea.

"Buttonholing" of the radial head through the anterior joint capsule is a known cause of irreducible anterior radial head dislocation associated with Monteggia injuries in pediatric patients. To the best of our knowledge, no report has described an injury consisting of buttonholing of the radial head through the annular ligament and a simultaneous radial head fracture in an adolescent. In the present case, the radiographic findings were a radial head fracture with anterior dislocation and lack of the anterior fat pad sign. Read More

Zhongguo Gu Shang 2016 Jul;29(7):677-680

Department of Orthopaedics, the Second People's Hospital of Pingliang City, Pingliang 744000, Gansu, China.

The terrible triad of elbow is a kind of complex elbow fracture dislocation, after reduction, it should get a concentric circles joint reduction and elbow stability, if radial and coronoid process fractures is less piece, the conservative treatment can be performed, but regularly follow up is mandatory. If surgical treatment was chosen, radial head fractures and the lateral collateral ligament complex must be repaired. Single lateral approach can be used and also can be combined with anteromedial approach in surgery. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2016 Mar;30(3):353-8

Objective: To investigate the feasibility of modified classification of terrible triad of the elbow and the effectiveness of treatment strategy which was chosen by modified classification results.

Methods: Between March 2007 and November 2013, 12 cases of terrible triad of the elbow were treated by operation. There were 5 males and 7 females with an average age of 37. Read More