Monteggia-like lesions: preliminary reports and mid-term results of a single center

Monteggia-like lesions: preliminary reports and mid-term results of a single center

Authors

  • Filippo Calderazzi Department of Medicine and Surgery, Orthopaedic Clinic, Parma University Hospital, Parma, Italy
  • Margherita Menozzi Department of Medicine and Surgery, Orthopaedic Clinic, Parma University Hospital, Parma, Italy
  • Alessandro Nosenzo Department of Medicine and Surgery, Orthopaedic Clinic, Parma University Hospital, Parma, Italy
  • Cristina Galavotti Dipartimento Scienze Chirurgiche Ospedale Maggiore Parma, U.O. Clinica Ortopedica
  • Sofia Solinas Department of Medicine and Surgery, Orthopaedic Clinic, Parma University Hospital, Parma, Italy
  • Enrico Vaienti Department of Medicine and Surgery, Orthopaedic Clinic, Parma University Hospital, Parma, Italy
  • Francesco Ceccarelli Department of Medicine and Surgery, Orthopaedic Clinic, Parma University Hospital, Parma, Italy

Keywords:

Monteggia-like; complex elbow fractures; outcomes; surgical treatment

Abstract

Background and aim of the work

Monteggia-like lesions are complex and rare elbow injuries. A detailed classification and a proper surgical treatment can provide quite good functional and radiological outcomes. The aim of this retrospective study was to evaluate the mid-term results of Monteggia-like lesions surgical treatment. The other purpose was to investigate whether the complexity of ulna and radius fractures could be prognostic factors of insufficient functional results.

Methods

Seven women and five men, with a mean age of 59,25 years who had sustained a Monteggia-like lesion were followed up clinically and radiologically after surgical treatment. The Mayo Elbow Performance Score (MEPS) and the Quick Disabilities of the Arm, Shoulder and Hand (QUICK-DASH) score were used for evaluation at a mean of 17,5 months postoperatively (12-26). The range of movement (ROM), patients’ satisfaction and neurological symptoms were also investigated. Osteolysis, implant loosening and heterotopic ossification were graded. Pearson’s test was used to correlate the different classification systems used (AO/OTA, Bado and Jupiter, PURCCS, Mason) with MEPS and QUICK-DASH score.

Results

The mean MEPS was 84,92 (65 to 100). The mean QUICK-DASH score was 18,75 (0 to 34,1). The mean active pronation and supination was 72,5° and 59,17°, respectively. The mean active ROM of the elbow was 101,43°. Heterotopic ossifications were absent in six cases but were found in six. No statistically significant correlation was found between the analyzed variables.

Conclusions

Quite good functional results can be obtained in Monteggia-like lesions if injury pattern is recognized and each component of the injury is addressed. Further studies are needed to determine any prognostic factors.

Author Biographies

Margherita Menozzi, Department of Medicine and Surgery, Orthopaedic Clinic, Parma University Hospital, Parma, Italy

Department of Medicine and Surgery, Orthopaedic Clinic, Parma University Hospital, 43100, Via Gramsci 14 Parma, Italy - Resident 

 

Alessandro Nosenzo, Department of Medicine and Surgery, Orthopaedic Clinic, Parma University Hospital, Parma, Italy

Department of Medicine and Surgery, Orthopaedic Clinic, Parma University Hospital, 43100, Via Gramsci 14 Parma, Italy - Resident

Sofia Solinas, Department of Medicine and Surgery, Orthopaedic Clinic, Parma University Hospital, Parma, Italy

Department of Medicine and Surgery, Orthopaedic Clinic, Parma University Hospital, 43100, Via Gramsci 14 Parma, Italy

Enrico Vaienti, Department of Medicine and Surgery, Orthopaedic Clinic, Parma University Hospital, Parma, Italy

Department of Medicine and Surgery, Orthopaedic Clinic, Parma University Hospital, 43100, Via Gramsci 14 Parma, Italy - Associate Professor - Chief 

Francesco Ceccarelli, Department of Medicine and Surgery, Orthopaedic Clinic, Parma University Hospital, Parma, Italy

Department of Medicine and Surgery, Orthopaedic Clinic, Parma University Hospital, 43100, Via Gramsci 14 Parma, Italy - Full Professor

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Published

04-11-2020

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Monteggia-like lesions: preliminary reports and mid-term results of a single center. Acta Biomed [Internet]. 2020 Nov. 4 [cited 2024 Mar. 29];91(4):e2020134. Available from: https://www.mattioli1885journals.com/index.php/actabiomedica/article/view/9864