Table 4.
Overview reported outcomes and complications of the included outcome studies on chronic Monteggia in children.
| Study | Follow-up time [months] | Radiological outcome† | Functional scoring ‡ | Clinical outcome Mean (F)lexion / (E)xtension at final follow-up (range or ±SD) |
Clinical outcome Mean (P)ronation / (S)upination at final follow-up (range or ±SD) |
Recorded complications |
|---|---|---|---|---|---|---|
| Bor4 | 42 (24-72) | Good (4) | NR | (F) 150° (E) 0° |
(P) 90° (S) 85° (-70-90°) |
Pin tract infection (1) |
| Kosev5 | 48 (30-66) | Good (3) Fair (1*) |
KEPS Excellent (3) Good (1) |
(F) 141.25° (135-150°) (E) -2.5° (-10-5°) |
(P) 67.5° (50-85°) (S) 86.25° (75-90°) |
Mild residual subluxation (1) |
| Di Gennaro6 | 66 (12-292) | Good (15) Fair (5*) Poor (1) Excised RH (1) (RH deformity (11)) |
KEPS Excellent (14) Good (4) Fair (4) PostOP mean 91 (65-100) |
(F) 134.32° (110-140°) (E) 5° (0-15°) |
(P) 83.86° (60-90°) (S) 74.55° (-45-90°) |
Transient posterior interosseus nerve palsy (1) Nonunion ulna (1) Delayed union (3) Residual subluxation (5) Redislocation (1) |
| Megahed7 | 19.5 (12-26) | Good (14) Fair (2*) |
MEPI Excellent (8) Good (5) Fair (3) |
Flexion-extension arc: mean 129° (110-145°) | Pronation-supination arc: mean 154° (140-170°) | Residual subluxation (2) |
| Lu8 | 18 (8-36) | Good (23) | KEPS\ PreOP mean 85 (75-95) PostOP mean 90 (70-100) |
(F) 135° (130-145°) (E) 5° (0-10°) |
(P) 70° (65-80°) (S) 80° (70-90°) |
None observed |
| Park9 | 45.6 (12-168) | Good (21) Poor (1) |
MEPI PreOP mean 81.1 (±9.4) PostOP mean 89.5 (±8.3) KEPS PreOP mean 80 (±8.2) PostOP mean 86.6 (±8.2) |
(F) 135° (130-140°) (E) 4° (0-10°) |
(P) 81° (60-80°) § (S) 71° (70-90°) |
Anterior radial head dislocation (1) Delayed union (2) Cosmetic (1) |
| Xu10 | 10 (6-17) | Good (5) | Broberg & Morrey Rate Index Excellent (5) |
(F) 142° (140-145°) (E) -1° (-5-0°) |
(P) 62° (60-70°) (S) 95° (90-110°) |
None observed |
| Ngoc Hung11 | 40.8 (24-61) | Good (12) Fair (1*) |
KEPS Excellent (9) Good (3) Fair (1) PreOP mean 75.38 PostOP mean 93.07 |
Flexion-extension arc: mean 127.7° (120-140°) | (P) 67.69° (50-75°) (S) 70° (40-80°) |
Nonunion ulna (1) Cubitus valgus (2) Anterior subluxation (1) |
| Agarwal12 | 13 (7-21) | Good (11) | NR | Mean increase in flexion 20° (10°-40°) Extension NR |
Mean increase supination: 1.8° (-20°-30°) Pronation NR |
NR |
| Chen13 | 21 (15-49) | Good (17) Fair (2*+1**) |
MEPI PreOP mean 80 (70-90) PostOP mean 94 (70-98) |
(F) 124° (100-140°) (E) -4.5° (-25-0°) |
(P) 65° (50-90°) (S) 77° (45-90°) |
Mild persistent radial head subluxation (2) Osteoarthritis (1) Transient post-operative compartment syndrome (1) |
| Eamsobhana14 | 42.2 (15-120) | Good (22) Fair (2*+4**) Poor (2) |
KEPS Excellent (23) Good (3) Fair (2) Poor (2) |
(F) 126.21° (100-140°) (E) -2.83° (-30-0°) |
(P) 71.55° (45-80°) (S) 73,28° (45-85°) |
Subluxation (2) Complete dislocation (2) Mild osteoarthritis (4) |
| Stragier15 | 132 (67-206) | Good (9) Fair (2*&**+3**) |
NR | (F) 146.1° (140-155°) (E) -5° (-30-0°) |
(P) 74.2° (45-90°) (S) 89.6° (70-100°) |
K-wire breakage (1) Postoperative infection (1) Subluxation: anterior (1) & posterior (1) Osteoarthritic changes (5) |
| Take16 | 12 (11-120) | Good (3) Fair (2*) |
KEPS Excellent (4) Good (1) PreOP mean 65 (50-75) PostOP mean 94 (80-100) |
(F) 140° (135-150°) (E) 2° (0-10°) |
(P) 81° (60-90°) (S) 84° (50-100°) |
Subluxation: anterior (1) & posterior (1) |
| Mazhar17 | 30.8 (3-70) | Good (7) | KEPS Excellent (6) Good (1) PostOP mean 96.4 (85-100) |
Flexion-extension arc: mean 137.9° (130- 150°) | (P) 65.7° (30-85°) (S) 72.1° (30- 90°) |
Flexion contracture (-10°, -35°) (2) Nonunion ulna (1) Heterotopic ossification (1) |
| He18 | > 12 months | Good (14) Poor (3) |
MEPI Excellent (10) Good (4) Fair (3) PostOP mean 92.1 (±2.7) |
NR | NR | Redislocation RH (3) |
| Wang19 | 27 (16-44) | Good (13) | KEPS Excellent (10) Good (3) PostOP mean 93.5 (80-100) |
Loss of extention (3) (20°, 30° & 35°) |
“No rotational limitations” | Delayed union ulnar osteotomy (3) Cubitus valgus (1) Skin irritation (< protruding plate) (1) |
| Gallone20 | 36 (12-132) | Good (8) Fair (6*) Poor (6) |
KEPS Excellent (14) Good (3) Fair (2) Poor (1) PostOP mean 88.7 (35-100) |
(F) 133.25° (100-140°) (E) 3.75° (0-15°) |
(P) 78.5° (5-90°) (S) 73.25° (-45-90°) |
Aseptic nonunion ulna (3) Delayed union (1) Residual subluxation (6) Complete dislocation (6) |
| Liao21 | 33.8 (8-87) | Good (30) Fair (2*) Poor (1) |
Mayor Elbow Score PreOP mean 79.4 (±7.6) PostOp mean 97.7 (±2.8) |
(F) 135.94° (±9.39°) (E) 0° (-5-1.5°) |
(P) 79.27° (±7.02°) (S) 83.39° (±7.3°) |
Redislocation (1) Subluxation (2) Mild ischemic contracture with recovery (1) Compartment syndrome with full recovery (1) |
| Soni22 | 36 (12-72) | Good (6) | NR | (F) 140° (E) 0° |
(P) 80.83° (70-90°) (S) 87.5° (75-90°) |
None observed |
| Kumar23 | 16.2 (14-24) | Good (16) Fair (1*) |
MEPI PreOP mean 76.76 (±1.71) PostOP mean 91.11 (±1.11) KEPS PreOP mean 76.94 (±2.24) PostOP mean 91.35 (±1.27) |
“full ROM” (16) Terminal flexion restriction (1) |
“Full ROM” | Mild subluxation (1) Hypertrophic scar (10) |
| Yuan24 | 25.9 (13-41) | Good (11) | Quick DASH 0 (10) >1 (1) PostOP mean 1.24 (0-13.6) |
Comparable to not-injured side (8) Not comparable to not-injured side (3) |
Comparable to not-injured side (8) Not comparable to not-injured side (3) |
Immediate post-op redislocation (1) Pin tract infection (1) Dysesthesiasis radial nerve territory (1) |
| Musikachart25 | 29.90 (12-84) | Good (17) Fair (2*) Poor (2) |
KEPS Excellent/ good (19) Fair/ poor (2) |
(F) 135.71° (100-150°) (E) 4.29° (0-40°) |
(P) 73.10° (45-85°) (S) 73.81° (30-90°) |
Posterior dislocation (2) Subluxation (2) |
| Çevi̇k26 | 62 (48-85) | Good (17) Fair (1**) |
OES Mean funct. score 90Mean sociopsych. score 85 Average pain score 86 |
(F) 130.8° (120-155°) (E)-0.8° (-30-10°) |
(P) 77.5° (45-90°) (S) 72° (0-90°) |
Mild osteoarthritic changes (1) |
† Good = Complete reduction radial head, no osteoarthritic changes, Fair = Radial head subluxation* or presence of osteoarthritic changes**, Poor = Radial head dislocation29
‡ KEPS = Kim Elbow Performance Score, MEPI = Mayo Elbow Performance Index, OES = Oxford Elbow Score - [Postoperative values if not specified]
NR (=Not Reported), RH (=Radial Head), § = not reliable reported value