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  • 11 -9 (83) 2025 - Yarashev T.Y. - CLINICAL AND RADIOLOGICAL CHARACTERISTICS OF A DIAPHYSEAL FRACTURE OF THE ULNA WITH DISLOCATION OF THE CAPE OF THE RADIUS (MONTEJE TYPE INJURY) IN CHILDREN

11 -9 (83) 2025 - Yarashev T.Y. - CLINICAL AND RADIOLOGICAL CHARACTERISTICS OF A DIAPHYSEAL FRACTURE OF THE ULNA WITH DISLOCATION OF THE CAPE OF THE RADIUS (MONTEJE TYPE INJURY) IN CHILDREN

CLINICAL AND RADIOLOGICAL CHARACTERISTICS OF A DIAPHYSEAL FRACTURE OF THE ULNA WITH DISLOCATION OF THE CAPE OF THE RADIUS (MONTEJE TYPE INJURY) IN CHILDREN

Yarashev T.Y. - Tashkent State Medical University

Resume

According to various authors, the incidence of forearm fractures (Monteggia-type injuries) ranges from 0.4 to 0.6%. Literature sources devoted to the treatment of ulnar diaphyseal fractures with radial head dislocation remain unsatisfactory. Materials and methods. The study is based on the treatment and analysis of 40 children with fractures of the ulnar diaphysis with dislocation of the radial head (Monteggia-type injuries). Right-sided injuries were found in 28 children, left-sided injuries in 12. There were 26 boys and 14 girls. In the course of the study of patients with this type of injury, we identified certain clinical and radiological features of each type of injury. Anterior Monteggia fractures were diagnosed in 28 patients. The fracture was located in the upper third of the ulna diaphysis in 4 cases and in the middle third in 14 cases. In this group of patients, transverse fractures were found in 6 cases and oblique fractures in 12 patients. All patients had angular displacement of the fragments toward the front within the range of 170-145 degrees; displacement of the fragments along the length and width was detected in 12 patients, and only along the width in four patients. External Monteggia injury with a fracture of the ulnar diaphysis was diagnosed in 15 patients. The ulnar diaphysis was damaged in the upper third in 4 cases and in the middle third in 11 patients. Three children had transverse fractures and 12 had oblique fractures. All patients had displacement of the fragments at an angle directed outward (170-140 degrees), two patients had displacement in width, and seven children had displacement in length and width. Posterior Monteggia injury with a fracture of the ulna diaphysis was diagnosed in seven patients. The fracture in all patients was localized in the middle third of the ulna (oblique and transverse), the fragments were displaced at an angle of 135-165 degrees, and the tip of the radial head in all patients was complete and directed posteriorly and medially. Results. Long-term treatment outcomes were studied in 26 patients. In 23 cases, good functional and anatomical results were observed. In 3 patients, the outcome of the injury was chronic Monteggia injury, which was the result of a displaced ulna of more than 20 degrees, leading to a recurrence of radial dislocation. Conclusions. The clinical picture of the disease consists of a combination of symptoms of a fracture of the ulna diaphysis and dislocation of the radial head. Treatment is mainly conservative. It is carried out sequentially. First, the dislocation of the radial head is reduced, followed by repositioning of the ulna fragments. The reduction of the head must be complete. After repositioning the fragments of the ulna, a control X-ray reveals angular displacement in diaphyseal fractures of up to 15 degrees and displacement in width in any direction of up to 1/2 diameter, which we consider acceptable, since a study of long-term results showed that the remaining displacement did not increase and limb growth was normal.

Key words: Trauma, elbow joint, children, treatment

First page

54

Last page

61

For citation:Yarashev T.Y. - CLINICAL AND RADIOLOGICAL CHARACTERISTICS OF A DIAPHYSEAL FRACTURE OF THE ULNA WITH DISLOCATION OF THE CAPE OF THE RADIUS (MONTEJE TYPE INJURY) IN CHILDREN//New Day in Medicine 9(83)2025 54-61 https://newdayworldmedicine.com/en/new_day_medicine/9-83-2025

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