Functional And Neurological Outcomes Of Closed Reduction And Percutaneous Pinning In Pediatric Monteggia Fracture

The aim of this study was to assess the neurological and functional recovery of children with Monteggia fracture following closed reduction and percutaneous pinning. Methods: It was a descriptive observational study, patients aged from 3 to 15 years with Monteggia fractures are taken in to consideration during the period between 2074/02/01 and 2074/7/30. Participants were selected on the basis of pre-determined inclusion/exclusion criteria. A total of 33 patients were included in the study. The demographics and pre- and post-operative outcomes were recorded in semi-structured proforma. Data entry, synthesis and descriptive analysis were done using MS EXCEL and SPSS version 16.0. Results: Total of 33 patients met the inclusion and exclusion criteria. The mean age was 8.21±3.4 years, with sex ratio (m: f) of 1.75: 1. Majority of the patients (57.58%) injured their left elbow and the most common mechanism of injury was fall while playing (36.36%). According to modified classification system for children, 60.61% had class C and 39.39% had class B Monteggia fracture. Five patients (15.15%) presented with PIN injury. All patients were treated with closed reduction and percutaneous pinning (IM RUSH nail) within 2.27±1.30 days after injury. The average duration of surgery was 62.42±23.55 minutes. The average duration of fracture healing was 5.39±1.6 weeks. Jupiter’s criteria for the evaluation of elbow function was used and at the time of cast removal, 6 (18.18%) had excellent, 10 (30.30%) had good, 13 (39.39%) had fair and 4 (12.13%) had poor functional recovery. Conclusions: This study concludes that most of the pediatric Monteggia fractures (class B and C) can be treated with closed reduction and percutaneous intramedullary nailing using RUSH pins. This technique has very good functional and neurological outcomes with fewer complications. Keywords: children; functional recovery; Intra-medullary nailing; jupiter’s criteria; Monteggia fractures.