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Long-Term Clinical and Radiographic Outcomes After Open Reduction for Missed Monteggia Fracture-Dislocations in Children by Koichi Nakamura, Kazuhiko Hirachi,

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Presentation on theme: "Long-Term Clinical and Radiographic Outcomes After Open Reduction for Missed Monteggia Fracture-Dislocations in Children by Koichi Nakamura, Kazuhiko Hirachi,"— Presentation transcript:

1 Long-Term Clinical and Radiographic Outcomes After Open Reduction for Missed Monteggia Fracture-Dislocations in Children by Koichi Nakamura, Kazuhiko Hirachi, Shigeharu Uchiyama, Masatoshi Takahara, Akio Minami, Toshihiko Imaeda, and Hiroyuki Kato J Bone Joint Surg Am Volume 91(6): June 1, 2009 ©2009 by The Journal of Bone and Joint Surgery, Inc.

2 Koichi Nakamura et al. J Bone Joint Surg Am 2009;91:1394-1404
©2009 by The Journal of Bone and Joint Surgery, Inc.

3 Koichi Nakamura et al. J Bone Joint Surg Am 2009;91:1394-1404
©2009 by The Journal of Bone and Joint Surgery, Inc.

4 Koichi Nakamura et al. J Bone Joint Surg Am 2009;91:1394-1404
©2009 by The Journal of Bone and Joint Surgery, Inc.

5 Figs. 2-A, 2-B, and 2-C Anular ligament reconstruction with use of a remnant of the ligament.
Figs. 2-A, 2-B, and 2-C Anular ligament reconstruction with use of a remnant of the ligament. Fig. 2-A Identification of the remnant (white arrows) of the anular ligament and the defect (black arrow) in the ligament. Koichi Nakamura et al. J Bone Joint Surg Am 2009;91: ©2009 by The Journal of Bone and Joint Surgery, Inc.

6 After the osteotomy of the ulna, the radial defect of the anular ligament was augmented with the palmaris longus tendon (white arrowhead). After the osteotomy of the ulna, the radial defect of the anular ligament was augmented with the palmaris longus tendon (white arrowhead). Koichi Nakamura et al. J Bone Joint Surg Am 2009;91: ©2009 by The Journal of Bone and Joint Surgery, Inc.

7 Illustration depicting the method of anatomical anular ligament reconstruction with use of the remnant of the anular ligament and the free palmaris longus tendon graft. Illustration depicting the method of anatomical anular ligament reconstruction with use of the remnant of the anular ligament and the free palmaris longus tendon graft. Koichi Nakamura et al. J Bone Joint Surg Am 2009;91: ©2009 by The Journal of Bone and Joint Surgery, Inc.

8 Anteroposterior and lateral radiographs, made nine years and two months after surgery, showing mild osteoarthritic changes at the radiohumeral joint. Anteroposterior and lateral radiographs, made nine years and two months after surgery, showing mild osteoarthritic changes at the radiohumeral joint. Koichi Nakamura et al. J Bone Joint Surg Am 2009;91: ©2009 by The Journal of Bone and Joint Surgery, Inc.

9 Scatterplot showing the relationships between the radiographic results at the time of follow-up, the interval between the injury and the operation, and the age at the time of the operation. Scatterplot showing the relationships between the radiographic results at the time of follow-up, the interval between the injury and the operation, and the age at the time of the operation. Open reduction of the radial head was successful in all cases in which the interval between the injury and the operation was less than three years or the age of the patient at the time of the operation was less than twelve years. When the interval to open reduction was three years or more and the age of the patient at the time of open reduction was twelve years or more, seven of eight patients had subluxation of the radial head or osteoarthritic (OA) changes in the elbow joint (solid circles). Koichi Nakamura et al. J Bone Joint Surg Am 2009;91: ©2009 by The Journal of Bone and Joint Surgery, Inc.

10 Koichi Nakamura et al. J Bone Joint Surg Am 2009;91:1394-1404
©2009 by The Journal of Bone and Joint Surgery, Inc.

11 Koichi Nakamura et al. J Bone Joint Surg Am 2009;91:1394-1404
©2009 by The Journal of Bone and Joint Surgery, Inc.

12 Koichi Nakamura et al. J Bone Joint Surg Am 2009;91:1394-1404
©2009 by The Journal of Bone and Joint Surgery, Inc.

13 Koichi Nakamura et al. J Bone Joint Surg Am 2009;91:1394-1404
©2009 by The Journal of Bone and Joint Surgery, Inc.

14 Koichi Nakamura et al. J Bone Joint Surg Am 2009;91:1394-1404
©2009 by The Journal of Bone and Joint Surgery, Inc.

15 Koichi Nakamura et al. J Bone Joint Surg Am 2009;91:1394-1404
©2009 by The Journal of Bone and Joint Surgery, Inc.


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