Percutaneous K wire fixation for Paediatric monteggia fracture

Abstract

Background: Monteggia, an Italian surgeon, first to describe the combination of a proximal ulna fracture and dislocated radial head. With the use of Kirschner wires, surgical stabilization could be achieved. The aim of the study was to determine closed reduction and  percutaneous k-wire fixation can maintain satisfactory reduction and fixation in pediatric Monteggia fractures.

Methods: Twelve patients  with Monteggia fractures were admitted to Zagazig University Hospital and Tripoli University HospitalLibya in this prospective study. All  were treated by close reduction and percutaneous k-wire fixation. Postoperatively, patients were weekly dressed and checked for pin  sites. AP / Lat X-rays elbow at 6 weeks for fracture union, wires removed. Using the Stewart Hundley, VAS, Mayo, and DASH scoring  systems, the elbow and forearm were evaluated for a range of motion in all directions.

Results: Age was distributed as 7.88±2.63 years,  regarding gender distribution males were 55.6% and females were 44.4%. Mechanism of injury FD was majority with 72.2% and DT 27.8%. Bado classification majority were type I 41.7%, type II 33.3%, type III 25%, and type IV no cases. The time of union was distributed as 2.72±0.80 months. Stewart Hundley's score excellent was the majority with 83.3%, good 8.3%, and fair 8.3%. Mayo's score was distributed  as 88.33±10.44; regard Mayo's excellent were majority with 66.7% then good and fair with 16.7% each. And regarding DASH excellent was  also the majority but with 61.1% then good 22.2% then fair 11.1% then poor only one case 5.6%.

Conclusions: Closed Reduction and  Percutaneous Kirschner Wires Fixation of Monteggia Fracture in Children are less invasive, and give satisfactory radiological and clinical  outcomes. Percutaneous interventions could be an option for Monteggia Fracture in Children.