Retrospective Study of Henry Approach and Boyd Approach for Missed Monteggia Lesions in Children
Objective:The purpose of this study is to investigated clinical effects of ulna osteotomy with open reduction of radial head for neglected Monteggia fracture in children,and preference for Henry approach and Boyd approach by a retro-spective study.Methods:From January 2010 to January 2020,search for patients with missed Monteggia fracture and un-derwent ulnar osteotomy and open reduction of radial head and divided into Henry group and Boyd group according to the open reduction approach for radial head.Gender,age,body mass index(BMI),time of injury,follow-up time,range of motion(ROM)of the elbow and Mayo elbow performance score(MEPS)at pre-operation and the end of follow-up and complications were recorded.SPSS 21.0 was used for statistical analysis.Results:A total of 45 patients were included in the study,24 cases in Henry group and 21 cases in Boyd group,including 27 males,14 cases in Henry group,13 cases in Boyd group;18 females,10 cases in Henry group,8 cases in Boyd group.Bado Ⅰ type 33 cases,including 17 cases in Hen-ry group,16 cases in Boyd group;and 12 cases in Bado Ⅲ group,including 7 cases in Henry group and 5 cases in Boyd group.ROM and MEPS at the end of follow-up were significantly improved in both groups compared with preoperative,however,there was no statistical difference between the two groups at the end of follow-up.Postoperative imaging was normal in Henry group 21 cases,17 cases in Boyd group,and 1 case resubluxation occurred in Henry group,2 cases in Boyd group,and 2 cases redislocation in Henry group,2 cases in the Boyd group,no radial nerve injury in the Henry group,and 1 case in the Boyd group.Conclusions:For neglected Monteggia fracture in children,both approaches can achieve good results,however,Henry approach can achieve better op-erative field and radial nerve exposure and protection.
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