Outcome of Monteggia Fracture Dislocation in Children Treated With K Wires in Nepalgunj Medical College

Abstract

Introduction: Monteggia fracture dislocations are rare injuries (<5%) where missed treatment results into deformity and dysfunction of forearm and hand. For the better functional result early diagnosis, accurate reduction of radial head and rigid fixation of ulna and immobilization during post-operative period for ligamentous healing around radius is vital. So operative treatment has been the primary method of treatment to prevent deformity and disability in monteggia fracture dislocation.

Aims: The aim of this study was to evaluate the time taken to unite fractures, complications encountered and assess the functional outcome on the basis of K-wire fixation in monteggia fracture dislocation in children.

Methods: A cross-sectional observational study was conducted in Nepalgunj Medical College and Teaching Hospital, Kohalpur, Banke with monteggia fracture dislocation in children.

Results: Thirty-two monteggia fracture dislocation in children between six to 14 years of age were treated with intramedullary K-wires after reduction of radial head. Seven cases had open reduction, and five needed trans-capitellar K-wire supplementation. Mean union time was 8.44±1.94 weeks ranging from seven to 12 weeks. The functional outcome on the basis of Anderson’s scoring system was excellent in 25(78.1%), good in three and optimal in four cases.

Conclusion: Monteggia fracture dislocation is better treated early and early mobilization of elbow joint is needed for better functional results.