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성인 2형 몬테지아 골절탈구의 수술적 치료 결과

Surgical Outcomes of the Monteggia Type 2 Fracture Dislocation in Adults

대한골절학회지 2019년 32권 1호 p.6 ~ 13
최성, 정대근, 변영수, 구태회, 하성수, 신동주,
소속 상세정보
최성 ( Choi Sung ) - 대구파티마병원 정형외과
정대근 ( Jeong Dae-Geun ) - 경산중앙병원 정형외과
변영수 ( Byun Young-Soo ) - 대구파티마병원 정형외과
구태회 ( Gu Tae-Hoe ) - 대구파티마병원 정형외과
하성수 ( Ha Sung-Soo ) - 대구파티마병원 정형외과
신동주 ( Shin Dong-Ju ) - 대구파티마병원 정형외과

Abstract


Purpose: This study examined clinical outcomes of Monteggia fracture type 2, which is the most common in adults with a high rate of accompanied injuries.

Materials and Methods: From June 2004 to November 2015, a retrospective study was performed on 12 patients diagnosed with Monteggia fracture type 2 with a follow-up period of at least 6 months after surgery. The clinical outcomes were evaluated using the Mayo elbow performance score (MEPS), and the existence of accompanied injures, radiological result, and complications were analyzed.

Results: Posterior instability was confirmed in all patients and accompanied fractures were detected in 9 patients (75.0%) on the radial head, whereas 10 patients (83.3%) were found on the coronoid process. The average arc of motion was 107° (70°?130°) and the mean MEPS was 89 (45?100). Additional re-operation due to re-dislocation, radioulnar synostosis, elbow instability, ulna nonunion, and radial head nonunion were performed in 4 cases (33.3%).

Conclusion: The Monteggia fracture type 2 is more commonly associated with radial head fractures and coronoid process fractures rather than other types, which causes elbow instability. Because the rate of additional surgery due to complications is high, the treatment of Monteggia fracture type 2 requires careful assessments.

키워드

Elbow; Ulna; Radius; Olecranon process; Monteggia’s fracture; Fracture dislocation

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