The aim of this retrospective multicentre study was to evaluate
mid-term results of the operative treatment of Monteggia-like lesions
and to determine the prognostic factors that influence the clinical
and radiological outcome. A total of 46 patients (27 women and 19 men), with a mean age
of 57.7 years (18 to 84) who had sustained a Monteggia-like lesion
were followed up clinically and radiologically after surgical treatment.
The Mayo Modified Wrist Score (MMWS), Mayo Elbow Performance Score
(MEPS), Broberg and Morrey Score, and Disabilities of the Arm, Shoulder
and Hand (DASH) score were used for evaluation at a mean of 65 months
(27 to 111) postoperatively. All ulnar fractures were stabilized
using a proximally contoured or precontoured locking compression
plate. Mason type I fractures of the radial head were treated conservatively, type
II fractures were treated with reconstruction, and type III fractures
with arthroplasty. All Morrey type II and III fractures of the coronoid
process was stabilized using lag screws.Aims
Patients and Methods
The outer diameter of the spacer ranges from 20–25–30 mm and the length from 40 to 70 mm. Two or three spacers can be combined via a special connector. Nails in the length 60 to 200 mm and the Ø 7 to 18 mm with the possibility of static or dynamic interlocking complete the modular system entirely made from Ti-6Al-4V.
The indication: Tumor: Humerus 8, Femur 16, Tibia 2, Postinfectious: Tibia 4, Posttramatic Femur 4, Tibia 2.
Biomechanical testing: the clamp connection spacer/ nail can neutralize axial loads which can not be expected in human beings. The clamp connection spacer/nail Ø 10 mm resisted an average axial load of 8,5 kN. This can be compared to a force of 850 kN (equivalent to 10 multiples of 85 kg body weight). The bending test with a nail Ø 10 mm shows that the spacer can resist long term loads from an occurring stress of 400 N/mm2 in the nail. Clinical evaluation: All spacers are still in place and all are full functioning, except 2; one spacer in the femur had to be replaced by a second spacer due to bone cement incorporated during first operation. One spacer was removed during amputation for recurrency of osteosarcoma. No infection, no loosing were reported.
