Study of monteggia fracture and dislocation and its treatment with plating

Abstract

Aim: The aim of this study was to assess the effectiveness of surgical treatment by open reduction and internal fixation of Monteggia fracture dislocation and evaluate the union of fracture, complications encountered during treatment and assess the functional outcome of the results. Methods: The present study consists of 20 cases of Monteggia fracture dislocation in adults treated by 3.5mm Dynamic compression plate/Locking Compression plates/Buttress plates and screws in the Department of Orthopaedics, SSG Hospital, Govt. Medical College, Baroda over the period of 1 year (2019-2020). There were fifteen male patients and five female patients who underwent surgery. Results: In our study patients are of age group between 19-59 years. Majority of our patients belonged to 21-40 age group. The ratio between Male to Female is 3:1. In our study labourers (manual & farm) were 13 (65%). Most of patients had sustained fracture with fall. 16 (80%) patients had Monteggia fracture with anterior radial head dislocation (Type 1). 1(5%) patient had Monteggia fracture with posterior radial head dislocation (Type 2). 1(5%) patient had Monteggia fracture with lateral radial head dislocation (Type 3). 2(10%) patients had Monteggia fracture with upper third radius fracture (Type 4). Both infections were superficial and healed eventually. 1(5%) patient went under non-union. Majority of patients are having excellent results 10 (50%). 9 patients had good result (45%). 1 patient had poor result (5%). Conclusion: The treatment plan in Monteggia Fracture dislocation depends on fracture pattern, soft tissue injury, patient co-morbidity, fixation resources. Fracture pattern, condition of soft tissue are important factors to be considered before selection of fixation method. The present case series showed that open reduction and internal fixation with DCP/Locking Plate is an effective treatment method in terms of better fixation with better outcome in terms of union time and complications rate.