• OBJECTIVE
    • The purpose of this study was to report the long-term follow-up results of chronic Monteggia fractures treated with angulation-translation osteotomy of ulna and closed reduction of the radial head.
  • DESIGN
    • Retrospective.
  • SETTING
    • Level 1 trauma center.
  • PATIENTS
    • We retrospectively reviewed 10 missed Monteggia fractures in children. The mean age of the patients was 7.5 years (range, 6-10 years), and there were 2 girls and 8 boys. The mean duration of time between initial injury and initial presentation was 1.7 years (range, 6 weeks to 5 years).
  • INTERVENTION
    • Closed reduction with ulna osteotomy or lengthening was performed in all 10 cases. Annular ligament reconstruction (ALR) was done in 2 cases. Final follow-up ranged from 3 to 20 years (mean 10 years).
  • MAIN OUTCOME MEASUREMENT
    • We assessed preoperative and postoperative radiographs to evaluate the quality of the radial head reduction. Clinical results were assessed according to the functional elbow score devised by Kim et al.
  • RESULTS
    • Radial head reduction was achieved and maintained in 8 of 10 cases after primary or secondary surgery. The radial head was mildly subluxated in one case and dislocated in another case at final follow-up. ALR was performed in only 2 cases. Open reduction and ALR is not required in every case, and its need should depend on intraoperative stability of radial head.