Frontiers in Pediatrics (Mar 2023)
The diagnosis and treatment of a special rare type of Monteggia equivalent fractures in children
- Fei Su,
- Fei Su,
- Fei Su,
- Min Li,
- Min Li,
- Min Li,
- Yishan Ma,
- Yishan Ma,
- Yishan Ma,
- Yating Yang,
- Yating Yang,
- Yating Yang,
- Xue Hao,
- Xue Hao,
- Xue Hao,
- Haoruo Jia,
- Haoruo Jia,
- Haoruo Jia,
- Youting Dang,
- Youting Dang,
- Youting Dang,
- Qingda Lu,
- Qingda Lu,
- Qingda Lu,
- Chenxin Liu,
- Chenxin Liu,
- Chenxin Liu,
- Shuai Yang,
- Shuai Yang,
- Shuai Yang,
- Huan Wang,
- Huan Wang,
- Huan Wang,
- Bing Wang,
- Bing Wang,
- Bing Wang,
- Qiang Jie,
- Qiang Jie,
- Qiang Jie
Affiliations
- Fei Su
- Department of Pediatric Orthopedics, Honghui Hospital, Xi’an Jiaotong University, Xi’an, China
- Fei Su
- Research Center for Skeletal Developmental Deformity and Injury Repair, School of Life Science and Medicine, Northwest University, Xi’an, China
- Fei Su
- Clinical Research Center for Pediatric Skeletal Deformity and Injury of Shaanxi Province, Xi’an, China
- Min Li
- Department of Pediatric Orthopedics, Honghui Hospital, Xi’an Jiaotong University, Xi’an, China
- Min Li
- Research Center for Skeletal Developmental Deformity and Injury Repair, School of Life Science and Medicine, Northwest University, Xi’an, China
- Min Li
- Clinical Research Center for Pediatric Skeletal Deformity and Injury of Shaanxi Province, Xi’an, China
- Yishan Ma
- Department of Pediatric Orthopedics, Honghui Hospital, Xi’an Jiaotong University, Xi’an, China
- Yishan Ma
- Research Center for Skeletal Developmental Deformity and Injury Repair, School of Life Science and Medicine, Northwest University, Xi’an, China
- Yishan Ma
- Clinical Research Center for Pediatric Skeletal Deformity and Injury of Shaanxi Province, Xi’an, China
- Yating Yang
- Department of Pediatric Orthopedics, Honghui Hospital, Xi’an Jiaotong University, Xi’an, China
- Yating Yang
- Research Center for Skeletal Developmental Deformity and Injury Repair, School of Life Science and Medicine, Northwest University, Xi’an, China
- Yating Yang
- Clinical Research Center for Pediatric Skeletal Deformity and Injury of Shaanxi Province, Xi’an, China
- Xue Hao
- Department of Pediatric Orthopedics, Honghui Hospital, Xi’an Jiaotong University, Xi’an, China
- Xue Hao
- Research Center for Skeletal Developmental Deformity and Injury Repair, School of Life Science and Medicine, Northwest University, Xi’an, China
- Xue Hao
- Clinical Research Center for Pediatric Skeletal Deformity and Injury of Shaanxi Province, Xi’an, China
- Haoruo Jia
- Department of Pediatric Orthopedics, Honghui Hospital, Xi’an Jiaotong University, Xi’an, China
- Haoruo Jia
- Research Center for Skeletal Developmental Deformity and Injury Repair, School of Life Science and Medicine, Northwest University, Xi’an, China
- Haoruo Jia
- Clinical Research Center for Pediatric Skeletal Deformity and Injury of Shaanxi Province, Xi’an, China
- Youting Dang
- Department of Pediatric Orthopedics, Honghui Hospital, Xi’an Jiaotong University, Xi’an, China
- Youting Dang
- Research Center for Skeletal Developmental Deformity and Injury Repair, School of Life Science and Medicine, Northwest University, Xi’an, China
- Youting Dang
- Clinical Research Center for Pediatric Skeletal Deformity and Injury of Shaanxi Province, Xi’an, China
- Qingda Lu
- Department of Pediatric Orthopedics, Honghui Hospital, Xi’an Jiaotong University, Xi’an, China
- Qingda Lu
- Research Center for Skeletal Developmental Deformity and Injury Repair, School of Life Science and Medicine, Northwest University, Xi’an, China
- Qingda Lu
- Clinical Research Center for Pediatric Skeletal Deformity and Injury of Shaanxi Province, Xi’an, China
- Chenxin Liu
- Department of Pediatric Orthopedics, Honghui Hospital, Xi’an Jiaotong University, Xi’an, China
- Chenxin Liu
- Research Center for Skeletal Developmental Deformity and Injury Repair, School of Life Science and Medicine, Northwest University, Xi’an, China
- Chenxin Liu
- Clinical Research Center for Pediatric Skeletal Deformity and Injury of Shaanxi Province, Xi’an, China
- Shuai Yang
- Department of Pediatric Orthopedics, Honghui Hospital, Xi’an Jiaotong University, Xi’an, China
- Shuai Yang
- Research Center for Skeletal Developmental Deformity and Injury Repair, School of Life Science and Medicine, Northwest University, Xi’an, China
- Shuai Yang
- Clinical Research Center for Pediatric Skeletal Deformity and Injury of Shaanxi Province, Xi’an, China
- Huan Wang
- Department of Pediatric Orthopedics, Honghui Hospital, Xi’an Jiaotong University, Xi’an, China
- Huan Wang
- Research Center for Skeletal Developmental Deformity and Injury Repair, School of Life Science and Medicine, Northwest University, Xi’an, China
- Huan Wang
- Clinical Research Center for Pediatric Skeletal Deformity and Injury of Shaanxi Province, Xi’an, China
- Bing Wang
- Department of Pediatric Orthopedics, Honghui Hospital, Xi’an Jiaotong University, Xi’an, China
- Bing Wang
- Research Center for Skeletal Developmental Deformity and Injury Repair, School of Life Science and Medicine, Northwest University, Xi’an, China
- Bing Wang
- Clinical Research Center for Pediatric Skeletal Deformity and Injury of Shaanxi Province, Xi’an, China
- Qiang Jie
- Department of Pediatric Orthopedics, Honghui Hospital, Xi’an Jiaotong University, Xi’an, China
- Qiang Jie
- Research Center for Skeletal Developmental Deformity and Injury Repair, School of Life Science and Medicine, Northwest University, Xi’an, China
- Qiang Jie
- Clinical Research Center for Pediatric Skeletal Deformity and Injury of Shaanxi Province, Xi’an, China
- DOI
- https://doi.org/10.3389/fped.2023.1120256
- Journal volume & issue
-
Vol. 11
Abstract
PurposeTo explore the characteristics, mechanism, treatment, and prognosis of head–neck separation type of Monteggia equivalent fractures in children.MethodsPatients with this injury were reviewed retrospectively. The lesion was characterized by a fracture of the ulnar with radial neck fracture but without dislocation of the radial head. Our classification was based on the direction of displacement and angulation of fractures on radiographs, divided into the extension-valgus type and flexion-varus type. The fractures were treated with reduction and internal fixation, depending on the fracture type. The clinical results were evaluated by using radiology and the Mayo Elbow Performance Score (MEPS).ResultsA total of 12 patients were followed up for an average of 40.5 months. The ulnar fractures were treated with closed reduction (CR) and K-wire fixation in one patient, elastic stable intramedullary nail (ESIN) fixation in four patients, open reduction (OR) and plate fixation in five, with no fixation in two. CR with ESIN fixation was successful in 11 patients with radial neck fractures, but one underwent OR and K-wire fixation. All fractures healed on time, with fewer complications (avascular necrosis in one patient, and bulk formation of metaphysis in another). The therapeutic efficacy was evaluated by using MEPS and was found to be excellent in 10 patients, good in one, and fair in another.ConclusionsThe head–neck separation type of Monteggia equivalent fractures in children is rare. Its characteristics are different from that of Monteggia fracture. The length and anatomic structure of the ulna should be restored and stabilized first, while the radial neck fracture should be treated with CR and ESIN fixation. Satisfactory clinical results can be achieved with fewer complications.
Keywords
