Abstract
Purpose of Study
We report the outcome of five cases of chronic paediatric Monteggia lesion treated with a modified Bell-Tawse procedure.
Methods
Five patients with a chronic Monteggia lesion were treated over an eight-year period (2004–2012) at our institution. All underwent a modified Bell-Tawse procedure. The patient medical records were retrospectively analysed. We report the outcome in five patients.
Results
Four girls and one boy were treated for a chronic Monteggia lesion in the period studied. The mean age at time of surgery was 8 years old (range 4–14 years). The mechanism of injury was post-traumatic in four of the five cases, while in one case the mechanism was uncertain. All children underwent modified Bell-Tawse procedure. All children ultimately required ulnar osteotomy, while two also required radial osteotomy. At a mean follow-up of 22 months (range 16–38 months), four children had experienced complications. Symptomatic metalwork was removed in one case, two children re-dislocated the affected joint, and one child required revision Bell-Tawse procedure. No nerve palsies were noted on follow-up.
Conclusion
Paediatric elbow trauma necessitates early, senior management. We report a series of five patients who underwent modified Bell-Tawse procedure for chronic Monteggia lesion. Four of the five children experienced complications. All required shortening osteotomies. The chronic Monteggia lesion is an unusual but troublesome presentation in the paediatric population. Further research in the area is necessary.
