Missed radial head dislocations in children associated with ulnar deformation: treatment by open reduction and ulnar osteotomy.

OBJECTIVE

To evaluate the results of open reduction and ulnar osteotomy on missed Monteggia fractures in children.

DESIGN

Retrospective review.

SETTING

Tertiary care center orthopaedic hospital in Pellenberg, Belgium.

PATIENTS/PARTICIPANTS: Six children between 2 and 6 years old who sustained a Monteggia fracture that was initially missed were treated at our institute. They presented in our hospital 5 to 59 weeks postinjury.

INTERVENTION

Open reduction of the radial head was performed, combined with a dorsal opening wedge osteotomy of the proximal ulna and fixation with plate and screws.

MAIN OUTCOME MEASUREMENTS

Mobility of the elbow was measured by an independent observer, evaluating flexion-extension and pronation-supination preoperatively and postoperatively.

RESULTS

All patients regained a normal range of motion, the radial head remained relocated, and the axis of the forearm remained normal.

CONCLUSION

This operation-open reduction of the radial head and osteotomy of the ulna-results in an excellent outcome for a missed Monteggia fracture in children.