Missed Monteggia Injuries in Children and Adolescents: A Treatment Algorithm
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Missed Monteggia Injuries in Children and Adolescents: A Treatment Algorithm. / Wintges, Kristofer; Cramer, Christopher; Mader, Konrad.
In: CHILDREN-BASEL, Vol. 11, No. 4, 391, 25.03.2024.Research output: SCORING: Contribution to journal › SCORING: Review article › Research
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TY - JOUR
T1 - Missed Monteggia Injuries in Children and Adolescents: A Treatment Algorithm
AU - Wintges, Kristofer
AU - Cramer, Christopher
AU - Mader, Konrad
PY - 2024/3/25
Y1 - 2024/3/25
N2 - Monteggia injuries are rare childhood injuries. In 25-50% of cases, however, they continue to be overlooked, leading to a chronic Monteggia injury. Initially, the chronic Monteggia injury is only characterized by a moderate motion deficit, which is often masked by compensatory movements. Later, however, there is a progressive valgus deformity, neuropathy of the ulnar nerve and a progressive deformity of the radial head ("mushroom deformity") with ultimately painful radiocapitellar arthrosis. In the early stages, when the radial head is not yet deformed and there is no osteoarthritis in the humeroradial joint, these injuries can be treated with reconstruction procedures. This can be achieved either by an osteotomy of the proximal ulna with or without gradual lengthening. If there is already a severe deformity of the radial head and painful osteoarthritis, only rescue procedures such as functional radial head resection or radial head resection with or without hemi-interposition arthroplasty can be used to improve mobility and, above all, to eliminate pain. In this review article, we provide an overview of the current treatment options of chronic Monteggia injury in children and adolescents and present a structured treatment algorithm depending on the chronicity and dysplastic changes.
AB - Monteggia injuries are rare childhood injuries. In 25-50% of cases, however, they continue to be overlooked, leading to a chronic Monteggia injury. Initially, the chronic Monteggia injury is only characterized by a moderate motion deficit, which is often masked by compensatory movements. Later, however, there is a progressive valgus deformity, neuropathy of the ulnar nerve and a progressive deformity of the radial head ("mushroom deformity") with ultimately painful radiocapitellar arthrosis. In the early stages, when the radial head is not yet deformed and there is no osteoarthritis in the humeroradial joint, these injuries can be treated with reconstruction procedures. This can be achieved either by an osteotomy of the proximal ulna with or without gradual lengthening. If there is already a severe deformity of the radial head and painful osteoarthritis, only rescue procedures such as functional radial head resection or radial head resection with or without hemi-interposition arthroplasty can be used to improve mobility and, above all, to eliminate pain. In this review article, we provide an overview of the current treatment options of chronic Monteggia injury in children and adolescents and present a structured treatment algorithm depending on the chronicity and dysplastic changes.
U2 - 10.3390/children11040391
DO - 10.3390/children11040391
M3 - SCORING: Review article
C2 - 38671608
VL - 11
JO - CHILDREN-BASEL
JF - CHILDREN-BASEL
SN - 2227-9067
IS - 4
M1 - 391
ER -