Open reduction and annular ligament reconstruction with fascia of the forearm in chronic monteggia lesions in children.

Abstract

Fifteen children with chronic Monteggia lesions were treated with open reduction, annular ligament reconstruction with fascia of the forearm, and ulnar osteotomy. Mean age was 8 years 3 months (range 3-16 years). The chronicity of missed Monteggia was from 6 weeks to 2 years (mean 12 weeks). All patients were classified as Bado type I, except one with Bado type III. Mean follow-up was 4 years 3 months after surgery. There was a loss of pronation in six cases with the mean of 16 degrees. However, only four cases had rotational loss; the others had a mean rotational arch increase of 5 degrees. The flexion arches improved in all patients, with a mean of 27.7 degrees. The functional result was excellent in 11 patients, good in 3 patients, and poor in 1 patient. This one-incision approach is safe in treating chronic Monteggia lesions in children.