RESUMO
The mechanism of trauma and late results of treatment were analyzed in 17 pediatric and 16 adult Monteggia lesions. Pediatric Monteggia lesions were almost entirely found to be the result of low energy trauma leading to a closed, noncomminuted fracture in an otherwise noninjured child. In the adult cases, however, these lesions were most often found to be the result of high energy trauma leading to open and comminuted fractures. Furthermore, 62% of the adults had other, and often more serious, injuries. Results at follow up (average 7 years) were excellent in the pediatric cases, whereas all adults had sequelae, especially regarding range of motion. The results of this study clearly suggest that a Monteggia lesion represents a more severe injury in the adult.
Assuntos
Fixação de Fratura/métodos , Manipulação Ortopédica , Fratura de Monteggia/etiologia , Fraturas da Ulna/etiologia , Atividades Cotidianas , Adolescente , Adulto , Idoso , Fenômenos Biomecânicos , Criança , Pré-Escolar , Feminino , Seguimentos , Fixação de Fratura/normas , Humanos , Masculino , Manipulação Ortopédica/normas , Pessoa de Meia-Idade , Fratura de Monteggia/diagnóstico por imagem , Fratura de Monteggia/terapia , Prognóstico , RadiografiaRESUMO
Late results (average 18 years posttrauma) after hip fractures in 17 children are reported. The average age at the time of fractures was 8.5 years (range 2 to 15 years). The treatment was conservative for undisplaced or slightly displaced transcervical and cervicotrochanteric fractures (Delbet's Type II and III) as well as for intertrochanteric fractures (Delbet's Type IV). The overall complication rate was 25%. Avascular necrosis of the femoral head was seen in two hips, premature epiphyseal closure with leg shortening in two cases, and a coxa vara in one hip. These complications only had resulted in few symptoms at follow up.