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Surgical Treatment of Monteggia-Like Lesions With a Modified Boyd Approach
INTRODUCTION: Monteggia-like lesions are rare injuries in adults that include a wide spectrum of complex fracture-dislocations of the proximal ulna and radius. In this retrospective study, we performed a modified Boyd approach and a standard surgical protocol for the treatment of these lesions. Our...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10460292/ https://www.ncbi.nlm.nih.gov/pubmed/37641781 http://dx.doi.org/10.1177/24715492231196622 |
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author | Kokkalis, Zinon T. Bavelou, Aikaterini Kalavrytinos, Dimitrios Sinos, George Antzoulas, Panagiotis Panagopoulos, Andreas |
author_facet | Kokkalis, Zinon T. Bavelou, Aikaterini Kalavrytinos, Dimitrios Sinos, George Antzoulas, Panagiotis Panagopoulos, Andreas |
author_sort | Kokkalis, Zinon T. |
collection | PubMed |
description | INTRODUCTION: Monteggia-like lesions are rare injuries in adults that include a wide spectrum of complex fracture-dislocations of the proximal ulna and radius. In this retrospective study, we performed a modified Boyd approach and a standard surgical protocol for the treatment of these lesions. Our aim was to evaluate the results of the operative treatment for patients with Monteggia-like lesions, using a modified Boyd approach. MATERIALS AND METHODS: We present a retrospective study of 14 patients who underwent surgical treatment for Monteggia-like lesions. Preoperative clinical and radiological evaluation was performed. In 5 cases radial head prosthesis was placed, and in 3 cases the radial fracture was stabilized with the use of interfragmental screws. Regarding the proximal ulnar fracture, ORIF-anatomical plate and ORIF-straight plate was used in 12 and 2 cases, respectively. RESULTS: Average clinical follow up was 16.9 months. Postoperatively, the mean Mayo Elbow Performance score was 83.4 points (range 70-100) and the mean visual analog scale was 1.7 (range 0-14). Mean flexion and loss of extension were 122.1° (range 80°-140°) and 21.4° (range 5°-40°), respectively. Mean supination of the forearm was 66.8° (range 50°-80°) and the mean pronation was 67.5° (range 60°-75°). Heterotopic ossification was observed in 3 patients (21.4%) and 1 patient developed stiffness (7.1%). The patient who developed stiffness underwent reoperation for plate removal and arthrolysis, with satisfactory results. CONCLUSIONS: The surgical treatment of Monteggia-like lesions in adults remains a challenge. In the present study, the use of a standard surgical protocol, with a modified Boyd approach, successfully restores the movement and stability of the elbow, with a low complication rate. |
format | Online Article Text |
id | pubmed-10460292 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-104602922023-08-28 Surgical Treatment of Monteggia-Like Lesions With a Modified Boyd Approach Kokkalis, Zinon T. Bavelou, Aikaterini Kalavrytinos, Dimitrios Sinos, George Antzoulas, Panagiotis Panagopoulos, Andreas J Shoulder Elb Arthroplast Original Scientific Research INTRODUCTION: Monteggia-like lesions are rare injuries in adults that include a wide spectrum of complex fracture-dislocations of the proximal ulna and radius. In this retrospective study, we performed a modified Boyd approach and a standard surgical protocol for the treatment of these lesions. Our aim was to evaluate the results of the operative treatment for patients with Monteggia-like lesions, using a modified Boyd approach. MATERIALS AND METHODS: We present a retrospective study of 14 patients who underwent surgical treatment for Monteggia-like lesions. Preoperative clinical and radiological evaluation was performed. In 5 cases radial head prosthesis was placed, and in 3 cases the radial fracture was stabilized with the use of interfragmental screws. Regarding the proximal ulnar fracture, ORIF-anatomical plate and ORIF-straight plate was used in 12 and 2 cases, respectively. RESULTS: Average clinical follow up was 16.9 months. Postoperatively, the mean Mayo Elbow Performance score was 83.4 points (range 70-100) and the mean visual analog scale was 1.7 (range 0-14). Mean flexion and loss of extension were 122.1° (range 80°-140°) and 21.4° (range 5°-40°), respectively. Mean supination of the forearm was 66.8° (range 50°-80°) and the mean pronation was 67.5° (range 60°-75°). Heterotopic ossification was observed in 3 patients (21.4%) and 1 patient developed stiffness (7.1%). The patient who developed stiffness underwent reoperation for plate removal and arthrolysis, with satisfactory results. CONCLUSIONS: The surgical treatment of Monteggia-like lesions in adults remains a challenge. In the present study, the use of a standard surgical protocol, with a modified Boyd approach, successfully restores the movement and stability of the elbow, with a low complication rate. SAGE Publications 2023-08-25 /pmc/articles/PMC10460292/ /pubmed/37641781 http://dx.doi.org/10.1177/24715492231196622 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Original Scientific Research Kokkalis, Zinon T. Bavelou, Aikaterini Kalavrytinos, Dimitrios Sinos, George Antzoulas, Panagiotis Panagopoulos, Andreas Surgical Treatment of Monteggia-Like Lesions With a Modified Boyd Approach |
title | Surgical Treatment of Monteggia-Like Lesions With a Modified Boyd Approach |
title_full | Surgical Treatment of Monteggia-Like Lesions With a Modified Boyd Approach |
title_fullStr | Surgical Treatment of Monteggia-Like Lesions With a Modified Boyd Approach |
title_full_unstemmed | Surgical Treatment of Monteggia-Like Lesions With a Modified Boyd Approach |
title_short | Surgical Treatment of Monteggia-Like Lesions With a Modified Boyd Approach |
title_sort | surgical treatment of monteggia-like lesions with a modified boyd approach |
topic | Original Scientific Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10460292/ https://www.ncbi.nlm.nih.gov/pubmed/37641781 http://dx.doi.org/10.1177/24715492231196622 |
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