CHRONIC MONTEGGIA LESIONS IN CHILDREN - COMPLICATIONS AND RESULTS OF RECONSTRUCTION

We retrospectively reviewed the results of operative treatment of chro nic Monteggia lesions (Dado type I or the equivalent) with anterior ra diocapitellar dislocation in severs patients, The mean age at tile tim e of the reconstruction was six years and nine months (range, eleven m onths to twelve years), and the mean time from the injury to the opera tion was twelve months (range, five weeks to thirty-nine months), The mean duration of follow-up was four years and six months (range, two y ears to eleven Sears and three months), There were fourteen complicati ons, including malunion of the ulnar shaft in one patient; residual ra diocapitellar subluxation in two patients (one anterior and one poster olateral); radio-capitellar dislocation (dynamic anterior subluxation of the radial head in supination) in one patient; transient ulnar-nerv e palsy in three patients (with residual weakness in awe); partial lac eration of the radial nerve in one patient; loss of tile fixation in t wo patients; and non-union of the ulnar osteotomy site, compartment sy ndrome, conversion reaction, and possible fibrous synostosis of the fo rearm in one patient each. The patients lost a mean of 36 degrees of p ronation and a mean of 27 degrees of supination of the forearm compare d with the contralateral, uninjured extremity, Two patients demonstrat ed a loss of flexion of the elbow of 8 and 13 degrees and three had a loss of extension (mean, 15 degrees) compared with the contralateral s ide, There were three good, two fair, and two poor results.