A new approach for surgical treatment of chronic Monteggia fracture in children

Abstract Purpose The aim of the study was to investigate the clinical outcomes of a combined anterior and posterior approach for the surgical treatment of chronic Monteggia fractures in children. Materials and methods From November 2010 to January 2018, 33 patients (27 boys and 6 girls) with chronic Monteggia fracture who were treated surgically by one surgeon of our department were retrospectively analyzed. In the surgical procedure, open reduction and excision of fibrous scar were performed with the anterior Henry’s approach, while ulnar osteotomy was carried out with a posterior approach. In cases of unstable radial head reduction, a trans-capitellar K wire was applied. Repair or reconstruction of the annular ligament (ALR) was not undertaken. Results The average follow-up of the patients was 33.8 months (range 8–87 months). At the last follow-up, Mayor Score and function of flexion and extension showed significant improvement compared to preoperative condition ( p Conclusion A combined anterior and posterior approach for surgery resulted in a satisfactory outcome due to the advantages of better exposure, more convenient intraoperative management, and facilitate for radial nerve exploration. Our study provided a new approach for the surgery of chronic Monteggia fractures.