Study of the Various Factors Involved in Monteggia Fractures Treated by Open Reduction and Internal Fixation in Government Medical College, Trichur

Author(s): Rohit Ashok Ranjolker1, Krishnakumar Cherungottil Viswanathanunni2

The various factors involved in Monteggia fractures treated by open reduction and
internal fixation (ORIF) were studied in patients presenting to Government Medical
College, Trichur. Its distribution based on age, gender, and nature of trauma, were
observed in the patients.
This study was a prospective descriptive study, conducted in Department of
Orthopaedics, Medical College, Thrissur from 1, January, 2016 to 1, July, 2017.
Patients were assessed according to age, sex, side of injury, co-morbidities and
final functional assessment was made according to Broberg and Morrey score. A
total of 37 patients were observed. The patients were assessed, deemed fit for
the study, and subjected to operation. Radial head reduction, fixation if needed,
then ulna fracture was opened, reduced, and fixed with plate and screws. Postoperative
plaster slab was applied, then converted to full above elbow cast, and
retained for as long as needed. Post-operative mobilization was by home
physiotherapy only.
Our study showed that open reduction and internal fixation of ulna outcome in
Monteggia fractures leads to good elbow function and minimal loss of physical
capacity. Immobilization of more than 2 months have very high chances of elbow
stiffness. Early active mobilization after surgery is necessary for good functional
outcome. Other than mild stiffness and loss of range of motion in some cases,
very few other complications were found in our series.
Rigid internal fixation of ulna and early active mobilization is the key to achieve a
good functional outcome and minimal loss of physical capacity in Monteggia
fractures. Very few of the complications that were described in the literature were
seen in the study. Even with restricted resources and minimal facilities, almost no
permanent or debilitating morbidity or complications were seen in our series. Early
active mobilization after surgery was the most important deciding factor for good
functional outcome. Prolonged immobilization of more than one month
consistently produces poor results