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Sci Rep 2022 Jun 17;12(1):10238. Epub 2022 Jun 17.

Department of Orthopedics, The First Affiliated Hospital of Guangxi Medical University, 6 Shuangyong Road, Nanning, Guangxi, China.

The present study aimed to explore the influence of ulnar bow on the surgical treatment of Bado type I missed Monteggia fracture in children. A retrospective review of 28 patients was conducted between November 2010 and June 2020. All patients were treated with open reduction of the radial head and ulnar opening wedge osteotomy without annular ligament reconstruction. Read More

J Orthop Surg Res 2022 Jun 7;17(1):303. Epub 2022 Jun 7.

University Centre for Orthopaedic, Trauma- and Plastic Surgery (OUPC), University Hospital Carl Gustav Carus, Technical University Dresden, Fetscherstraße 74, 01307, Dresden, Germany.

Background: Monteggia fractures and Monteggia-like lesions result after severe trauma and have high complication rates. Preliminary biomechanical studies suggested a correlation between ulnar fracture localization and clinical result.

Objectives: Key objective was to evaluate whether the site of the ulnar fracture can be correlated to clinical outcome after open reduction and internal stabilization. Read More

Ortop Traumatol Rehabil 2022 Apr;24(2):79-86

Klinika Ortopedii i Ortopedii Dziecięcej, Centralny Szpital Kliniczny Uniwersytetu Medycznego w Łodzi, Polska / Orthopedics and Pediatric Orthopedics Department, Central Teaching Hospital of the Medical University of Lodz, Poland.

Background: The term Monteggia fracture refers to a class of injuries encompassing the fracture of the proximal end of the ulna with subluxation or dislocation of the radial head. These injuries account for 0.4-1% of all forearm fractures in children. Read More

J Orthop Case Rep 2021 Oct;11(10):17-20

Department of Orthopedic Surgery, William Beaumont Hospital, Royal Oak, Michigan.

Introduction: Monteggia fracture-dislocations are rare and complex injuries that usually involve a fracture of the proximal ulna associated with a proximal radioulnar and radiocapitellar joint dislocations. These injuries comprise <1% of all pediatric forearm fractures. We report on a pediatric Monteggia fracture-dislocation variant that included an irreducible divergent ulnohumeral joint dislocation, an irreducible anterior radial head dislocation, and a proximal and distal radius and ulna fracture. Read More

Jt Dis Relat Surg 2022 28;33(1):40-50. Epub 2022 Mar 28.

Department of Orthopedics, Shanghai Sixth People's Hospital, 200233 Shanghai, China.

Objectives: In this study, we present a specified hinge positioning method to achieve satisfying and steerable lengthening and angulation to correct forearm multiple hereditary exostoses (MHE) combined with severe radiocapitellar joint dislocation using Ilizarov ring fixators.

Patients And Methods: Between January 2014 and December 2018, a total of 30 forearms of 23 patients (11 males, 12 females; mean age: 18.3±6. Read More

Clin Orthop Relat Res 2022 Jul 10;480(7):1354-1370. Epub 2022 Mar 10.

Department of Orthopedics, E-Da Hospital, Kaohsiung, Taiwan.

Background: The treatment of complex persistent elbow instability after trauma is challenging. Previous studies on treatments have reported varied surgical techniques, which makes it difficult to establish a therapeutic algorithm. Furthermore, the surgical procedures may not sufficiently restore elbow stability, even with an additional device, and a noted high rate of arthritis progression. Read More

J Med Imaging Radiat Oncol 2022 Feb 27. Epub 2022 Feb 27.

Department of Orthopaedics, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.

Elbow dislocation is the second most common type of joint dislocation in adults and the most common joint dislocation in children. These dislocations are commonly associated with significant soft tissue injury and/or fractures. Anterior dislocation of the radio-capitellar articulation is uncommon. Read More

Orthop Surg 2022 Apr 22;14(4):769-774. Epub 2022 Feb 22.

Department of Orthopaedics, Affiliated Zhongshan Hospital of Dalian University, Dalian, China.

Background: Simultaneous dislocation of the elbow, radioulnar joint and proximal radius fracture with rotary noose injury to the medial ulna tubercle is extremely rare. An emergency surgery was performed to reduce it. The radial head with the backbone was reset after two hammers were fixed, then the radial capitulum safety was fixed with a locking plate. Read More

BMC Surg 2022 Feb 17;22(1):60. Epub 2022 Feb 17.

Department of Orthopaedics, Shenzhen Ping Le Orthopaedic Hospital, Shenzhen, 518000, Guangdong, China.

Background: Ipsilateral fracture of the radial shaft with dislocation of the radial head was a rare injury, but a delayed radial head dislocation after radial shaft fracture fixation was more extremely rare.

Case Presentation: A 39-year-old man fell from the height on his outstretched hand and injured his left, non-dominant forearm. Preoperative radiographs demonstrated a comminuted fracture of the proximal third of the radius but with no apparent dislocation of the distal or proximal radioulnar joints or the elbow. Read More

Medicine (Baltimore) 2022 Feb;101(6):e28661

Department of Orthopaedics Surgery, Jeonbuk National University Medical School, Research Institute for Endocrine Sciences and Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, 567 Baekje-ro, Dukjin-gu, Jeonju, Republic of Korea.

Rationale: Traumatic radial head dislocation (RHD) can occur due to hyperpronation injury with sequential disruption of the annular ligament, quadrate ligament, and the interosseous membrane. Although studies have shown that traumatic RHD is generally associated with Monteggia fracture-dislocation, traumatic RHD occurring with ipsilateral radial shaft fractures has rarely been reported. Delayed RHD secondary to the malunion of isolated radial shaft fractures is extremely rare. Read More

World J Orthop 2021 Nov 18;12(11):954-960. Epub 2021 Nov 18.

Maternity-Childhood Department, Division of Paediatrics, "Cannizzaro" Hospital, Catania 95124, Italy.

Background: Monteggia fractures are uncommon injuries in paediatric age. Treatment algorithms assert that length-unstable fractures are treated with plate fixation. In this case report, intramedullary fixation of an acute length-unstable Monteggia fracture allowed a stable reduction to be achieved, along with an appropriate ulnar length and alignment as well as radio capitellar reduction despite the fact that the orthopaedic surgeon did not use a plate for the ulnar fracture. Read More

Acta Paediatr 2022 Apr 14;111(4):756-759. Epub 2022 Feb 14.

Kimura Children and Family Clinic, Izumo, Japan.

A pulled elbow is a common childhood orthopaedic injury that is usually caused by longitudinal traction on the hand. The pathophysiological mechanism of a pulled elbow involves interposition of the annular ligament into the radiohumeral joint. Recent ultrasonographic studies have shown that both the supinator muscle and annular ligament were trapped into the radiohumeral joint. Read More

J Am Vet Med Assoc 2021 11 10;259(12):1466-1470. Epub 2021 Nov 10.

From the Wildlife Conservation Society, Zoological Health Program, Bronx, NY 10460.

Case Description: A 3-year-old 5-kg sexually intact female silvery langur housed in a single-species group at a zoological institution was presented because of acute trauma to the left forelimb.

Clinical Findings: Radiography of the left forelimb revealed a type II Monteggia fracture (proximal ulnar fracture with cranial displacement and caudal luxation of the radial head). During surgery, disruption of the annular ligament and rupture of the lateral collateral ligament were noted. Read More

JBJS Case Connect 2021 10 14;11(4). Epub 2021 Oct 14.

Anne Arundel Medical Center, Annapolis, Maryland.

Case: A 7-year-old boy sustained a Monteggia fracture-dislocation. Corrective osteotomy of the ulna was performed to restore proper forearm anatomy and achieve radial head reduction. Recurrent radial head instability was noted postoperatively, and magnetic resonance imaging indicated recurrent dislocation of the radial head with, notably, an entrapped brachialis tendon and annular ligament. Read More

J Hand Surg Am 2021 11 7;46(11):1006-1015. Epub 2021 Sep 7.

Department of Orthopedics, Icahn School of Medicine at Mount Sinai, New York, NY. Electronic address:

Monteggia fractures classically involve a proximal ulna fracture with an associated radial head dislocation. The presence of radial head/neck fracture and comminution of the proximal ulna with coronoid involvement elevates the complexity of surgical reconstruction considerably. The Jupiter classification captures this injury pattern as a subgroup of Bado posterior Monteggia lesions. Read More

J Orthop Trauma 2022 Feb;36(2):65-73

Department of Orthopaedic Surgery, National University Health System (NUHS), Singapore.

Objectives: To review surgical management and outcomes of missed pediatric Monteggia fractures.

Data Sources: A systematic review was conducted using PubMed, Medical Literature Analysis and Retrieval System Online (MEDLINE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), and the Cochrane Library from inception through March 2, 2020. The keywords were "Monteggia fracture," "missed Monteggia," "neglected Monteggia," "chronic Monteggia," and "chronic radial head dislocation. Read More

JBJS Essent Surg Tech 2021 Apr-Jun;11(2). Epub 2021 Apr 19.

Monroe Carrell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee.

Background: Although many pediatric Monteggia fractures can be treated nonoperatively, the presence of any residual radiocapitellar subluxation following ulnar reduction mandates a more aggressive approach to restore and maintain ulnar length. In younger children, restoration and maintenance of ulna length may be achieved through intramedullary fixation of the ulnar shaft.

Description: A Steinmann pin or flexible intramedullary nail is introduced percutaneously through the olecranon apophysis and advanced within the medullary canal to the ulnar fracture site. Read More

J Hand Surg Am 2022 May 10;47(5):481.e1-481.e9. Epub 2021 Jul 10.

Baltalimani Bone Diseases Research Hospital Hand Surgery Clinic, University of Health Science Turkey Medical School, İstanbul.

Purpose: Opening-wedge osteotomy of the ulna restores normal ulnar length and corrects the angulation of the ulna in patients with chronic Monteggia fracture-dislocations. In addition, this eases the reduction of the radial head. Morbidity caused by annular ligament reconstruction surgery can be prevented by preserving the intact annular ligament. Read More

J Orthop Case Rep 2021 ;11(1):20-22

Department of Orthopedics and Traumatology, Medicine Faculty of Istinye University, Istanbul / Turkey.

Introduction: A pediatric radial neck fracture, when the diagnosis is delayed, is still a challenging problem for the treating orthopedic surgeon. We report a pediatric patient with late presenting radial neck fracture and results of open reduction and fixation with Kirschner wires.

Case Report: A 13-year-old right-handed girl fell on an out-stretched right arm after being tackled during playing basketball and had a radial neck fracture. Read More

Orthop Traumatol Surg Res 2022 02 19;108(1):102963. Epub 2021 May 19.

Service de Chirurgie Orthopédique et Réparatrice de l'Enfant, hôpital Trousseau, Université Sorbonne, Paris, France.

The incidence of untreated Monteggia fracture-dislocations is not insignificant. But there is no consensus as to the surgical indication and best surgical technique to use. Single-stage reduction of the radial head through an elbow arthrotomy and ulnar osteotomy is a complex surgical procedure that requires stabilization of the ulnar segments during every step of the intervention. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2021 May;35(5):562-566

Department of Orthopedics, Yantaishan Hospital, Yantai Shandong, 264000, P.R.China.

Objective: To explore the effectiveness of annular ligament reposition and repair via Henry's approach for Monteggia fracture in children.

Methods: A clinical data of 21 children with Monteggia fractures was retrospectively analysed, who underwent open reduction of the radial head and annular ligament reposition and repair via Henry's approach between May 2015 and July 2019. There were 11 boys and 10 girls with an average age of 8 years and 1 month (range, 4 years and 5 months to 14 years and 4 months). Read More

Ortop Traumatol Rehabil 2021 Apr;23(2):79-91

Oddział Chirurgii Urazowo-Ortopedycznej, Szpital Dziecięcy im. prof. dr. med. Jana Bogdanowicza, Warszawa, Polska / Department of Trauma and Orthopaedic Surgery, Prof. Jan Bogdanowicz Children's Hospital, Warsaw, Poland.

Background: The purpose of this paper is to evaluate the usefulness of radiographic indices of humero-radial joint instability in order to predict treatment outcomes in Monteggia fractures.

Material And Methods: A retrospective analysis was conducted in a group of patients who underwent closed reduction and internal titanium elastic nail (TEN) fixation of the ulna and closed reduction of a dislocation of the radial head between 2016 and 2018. The indications for intrame-dullary fixation comprised transverse or short oblique fractures. Read More

Orthop Surg 2021 Jun 4;13(4):1437-1442. Epub 2021 May 4.

VietDuc University Hospital, Hanoi, Vietnam.

Background: The traumatic dislocation of the radial head in children is commonly treated by closed reduction. Sometimes, however, this strategy of treatment may not be effective due to the location of soft tissues in the radio-shoulder joint. The literature presents a few cases of the irreducible radial head dislocation with ulnar plastic deformation. Read More

Medicine (Baltimore) 2021 Mar;100(10):e25129

Department of Orthopaedic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology.

Abstract: A neglected Monteggia fracture is defined as the fracture of the proximal ulna associated with radial head dislocation (RHD) without undergoing any treatment for 4 weeks or more after injury. One-stage operation of ulnar corrective osteotomy and open reduction of RHD might result in many complications. Therefore, a two-stage strategy, including ulnar osteotomy (UO) with or without annular ligament reconstruction (ALR), was adopted at our institute since 2010. Read More

Int Orthop 2021 05 23;45(5):1299-1308. Epub 2021 Feb 23.

Division of Orthopaedic and Trauma Surgery, Sahel General Hospital, University Medical Centre, PO Box 99/25, Ghoubeiry, Beirut, Lebanon.

Purpose: The purpose of this study is to evaluate the results of using a lateral hinged external fixator as an adjunct stabilizer in the treatment of a variety of acute destabilizing elbow injuries.

Methods: A retrospective review was performed on the medical records of patients in whom a lateral monolateral elbow hinged external fixator was applied by the senior author. The indication to apply the fixator corresponded to a variety of acute injury patterns ranging from simple elbow trauma or dislocation to complex fracture-dislocation, and the decision was based on either the presence of recurrent or persistent instability in any direction and/or to secure a vulnerable or weak bony fixation or soft tissue repair as intra-operatively judged by the surgeon. Read More

Orthop Surg 2021 Apr 22;13(2):530-536. Epub 2021 Feb 22.

Department of Orthopaedic Surgery, Hong Hui Hospital, Xi'an Jiaotong University, Xi'an, China.

Objective: To analyze the risk factors of elbow stiffness following open reduction and internal fixation of the terrible triad of the elbow joint.

Methods: A retrospective study was conducted of 100 patients with the terrible triad of the elbow joint, who had been treated at our hospital from January 2015 to December 2018. All patients were treated with a loop plate to repair the ulnar coronoid process. Read More

Orthop Traumatol Surg Res 2021 04 29;107(2):102829. Epub 2021 Jan 29.

Département d'orthopédie et traumatologie, CHU de Dijon, 21000 Dijon, France; INSERM UMR1093-CAPS, université Bourgogne-Franche-Comté, 21000 Dijon, France. Electronic address:

Isolated traumatic radial head dislocation is exceedingly rare in adults, usually diagnosed on an emergency basis, and reduced by external manoeuvres. If the diagnosis is not made immediately, external reduction is no longer feasible. Various options have been described for treating these chronic forms, including therapeutic abstention, radial head resection and annular ligamentoplasty combined, if appropriate, with osteotomy of the ulna. Read More

Clin Shoulder Elb 2020 Mar 21;23(1):27-30. Epub 2020 Feb 21.

Department of Shoulder and Elbow, Fundación Santa Fé de Bogotá, Bogotá, Colombia.

Osborne-Cotterill lesion is an osteochondral fracture located in the posterolateral margin of the humeral capitellum, which may be associated with a defect of the radial head after an elbow dislocation. This lesion causes instability by affecting the lateral ulnar collateral ligament over its capitellar insertion, which is associated with a residual capsular laxity, thereby leading to poor coverage of the radial head, and hence resulting in frequent dislocations. We present a 54-year-old patient, a physician who underwent trauma of the left elbow after falling from a bike and suffered a posterior dislocation fracture of the elbow. Read More

J Orthop Surg (Hong Kong) 2020 Sep-Dec;28(3):2309499020964082

Department of Orthopedic Surgery, 75445Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India.

Introduction: Neglected Monteggia fracture dislocation in children leads to significant restriction of daily activities by causing decreased range of motion at elbow, stiffness, deformity, and neurological compromise. Various treatment strategies have been described in the literature and one of them is ulnar osteotomy combined with reduction of radial head and annular ligament reconstruction.

Aim: The aim of this study was to evaluate the results of step-cut osteotomy without the use of bone grafting with reconstruction of annular ligament in the management of neglected Monteggia fracture dislocation in children. Read More

Bone Joint J 2020 Dec;102-B(12):1620-1628

Department of Trauma and Orthopaedic Surgery, BG Unfallklinik Frankfurt am Main, Frankfurt, Germany.

Aims: To evaluate the outcomes of terrible triad injuries (TTIs) in mid-term follow-up and determine whether surgical treatment of the radial head influences clinical and radiological outcomes.

Methods: Follow-up assessment of 88 patients with TTI (48 women, 40 men; mean age 57 years (18 to 82)) was performed after a mean of 4.5 years (2. Read More