Stability-based assessment of Monteggia-type injuries predicts failure of treatment

Ultrasonographic evaluation of radial nerve injuries associated with pediatric chronic monteggia lesions

INTRODUCTION

To determine the ultrasonographic evaluation of the radial nerve (RN) before correction of chronic pediatric Monteggia lesions in patients with suspected nerve injury.

METHODS

Twelve consecutive children with Monteggia lesions were investigated. The cross-sectional area (CSA) of the nerve and the nerve-to-skin (N-S) distance were determined by ultrasonography at 3 levels: 5 cm proximal to the humeroradial joint (L_prox), a horizontal line through the humeroradial joint (L_mid), and 2.5 cm distal to the humeroradial joint (L_dist).

RESULTS

The CSA was greater on the injured side than on the unaffected side at L_prox and at L_mid (P < 0.01), but no difference was noted for posterior interosseous nerve (PIN) at L_dist (P = 0.445). The N-S values were greater on the unaffected side than on the injured side (P < 0.01), but there was no difference at L_dist in superficial RN and PIN.

DISCUSSION

Ultrasonography allowed the preoperative assessment of the severity of RN injuries in chronic pediatric Monteggia lesions. Muscle Nerve 59:326-330, 2019.