Bado type III Monteggia fractures have a high injury- and treatment-related complication rate: a single center study of 73 fractures.

IF 2.5 2区医学 Q1 ORTHOPEDICS

Acta Orthopaedica Pub Date : 2024-10-14 DOI:10.2340/17453674.2024.42111

Kaj Zilliacus, Yrjänä Nietosvaara, Ilkka Helenius, Niko Kämppä, Ilkka Vuorimies, Petra Grahn

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引用次数: 0

Abstract

Background and purpose: Monteggia fractures can be problematic injuries. The aim of this population-based study is to evaluate the risk of complications according to the Bado types, clinical outcome, and incidence.

Methods: 72 children (median age 6, range 2-11 years) with 73 Monteggia fractures treated during 2014-2022 were identified from the institutional fracture register. Timing of diagnosis, complications, and method of treatment were registered. Outcomes were assessed at mean 4 years (1-9) follow-up in 68 (94%) children. The census population (< 16 years old) in Helsinki metropolitan area during the study period was assessed.

Results: Bado types I (n = 43) and III (n = 27) comprised all but 3 of the fractures. Diagnosis was made on admission in 57, and with a 1-8-day delay in 16 children. 8 children had sustained an associated nerve injury. 35 children were treated operatively, 7 after failed closed treatment. 4 reoperations were performed, including 3 ulnar osteotomies. The risk of complications (odds ratio [OR] 4.9, 95% confidence interval [CI] 1.7-14) and closed treatment failures (OR 12.3, CI 1.3-118) was higher in Bado type III than in type I injuries. 60 children attended for clinical follow-up, all had congruent radio-humeral joints and full range of elbow and forearm motion. Mean PedsQL was 94 (72-100) and QuickDash 3 (0-13). 8 additional children reported normal elbow functions by phone. The calculated mean annual incidence of Monteggia injuries was 2.9/100,000 children.

Conclusion: Monteggia fractures are rare (2.9/100,000 yearly). Bado type III injuries are associated with a high risk of complications.

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巴多 III 型蒙泰加骨折具有较高的损伤和治疗相关并发症发生率：对 73 例骨折进行的单中心研究。

背景和目的：Monteggia骨折可能是一种棘手的损伤。这项基于人群的研究旨在根据 Bado 类型、临床结果和发生率评估并发症的风险。方法：从机构骨折登记册中确定了 72 名儿童（中位年龄 6 岁，范围 2-11 岁），他们在 2014-2022 年期间接受了 73 次 Monteggia 骨折治疗。对诊断时间、并发症和治疗方法进行了登记。对 68 名（94%）儿童平均 4 年（1-9 年）的随访结果进行了评估。对研究期间赫尔辛基市区的人口普查（小于16岁）结果进行了评估：除 3 例骨折外，其余均为 I 型（43 例）和 III 型（27 例）骨折。57名儿童在入院时得到诊断，16名儿童的诊断延迟了1-8天。8名儿童伴有神经损伤。35名患儿接受了手术治疗，其中7名患儿在闭合治疗失败后接受了手术治疗。进行了4次再次手术，包括3次尺骨截骨手术。巴多III型损伤的并发症风险（几率比[OR] 4.9，95%置信区间[CI] 1.7-14）和封闭治疗失败风险（OR 12.3，CI 1.3-118）高于I型损伤。60名患儿接受了临床随访，所有患儿的桡肱关节均完全吻合，肘部和前臂均能完全活动。平均 PedsQL 为 94（72-100），QuickDash 为 3（0-13）。另有 8 名儿童通过电话报告肘关节功能正常。计算得出的肘关节损伤年平均发生率为 2.9/100,000：结论：肘关节骨折非常罕见（2.9/100,000）。结论：Monteggia骨折非常罕见（每年2.9/100000）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Orthopaedica 医学-整形外科

CiteScore

6.40

自引率

8.10%

发文量

105

审稿时长

4-8 weeks

期刊介绍： Acta Orthopaedica (previously Acta Orthopaedica Scandinavica) presents original articles of basic research interest, as well as clinical studies in the field of orthopedics and related sub disciplines. Ever since the journal was founded in 1930, by a group of Scandinavian orthopedic surgeons, the journal has been published for an international audience. Acta Orthopaedica is owned by the Nordic Orthopaedic Federation and is the official publication of this federation.