RAMAZAN ATİÇ, AZAD YILDIRIM, ŞEHMUS YİĞİT, ABDULKADİR AYDIN
Annals of Clinical and Analytical Medicine - 2018;9(4):323-328
Aim: Presently, there are few large-scale studies and no clear consensus on the type of osteotomy or ligamentoplasty to be performed in neglected Monteggia fractures-dislocations cases. The goal of this study was to report the results from neglected Monteggia fractures and dislocations. Material and Method: Thirteen children and adolescents with neglected Monteggia fractures and dislocations were treated between 2009 and 2012. There were 11 males and two females with a mean age of 8.5 (range 215) years. Based on the BADO classification, 11 patients had type 1, one patient had type 3, and one patient had type 4 injuries. Time delay from symptom onset to fracture was 8.84 (3-24) months. The data were analyzed using R version 3.1.1 and multiple statistical analyses were conducted. Results: A postoperative Mayo Elbow Performance Index (MEPI) at the time of follow-up was recorded. Nine patients received an excellent grade, while three had good and one had a fair result with no poor results recorded. Radiographically, there were nine good, four fair, and no poor score results. The length of hospitalization was a mean of 3 days. The mean duration of follow-up was 2.9 (range 1.5-4.5) years from the initial presentation, and only one patient developed subluxation for which no additional intervention was performed. Discussion: This case series demonstrates that early diagnosis increases the success rate in patients younger than 10 years and less than a 1-year interval between the trauma and diagnosis. Unless it is kept for a prolonged time, a condyloradial pin can be applied in necessary cases. Level of evidence: IV
