Correlation between inner epiphysis ulna radius length ratio and prognosis of Monteggia fractures in children: a multicenter study

Abstract The forearm function in children is influenced by several factors, with the length relationship between the ulna and radius being particularly important. However, due to the underdevelopment of cartilage in children, assessing this length relationship through imaging techniques is challengi...

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Main Authors: Siyin Feng, Yangfei Yi, Zhenqi Song, Junjie Lu, Qingfeng Zhou, Jie Wen, Sheng Xiao, Yufei Li
Format: Article
Language:English
Published: Nature Portfolio 2025-02-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-89751-1
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author Siyin Feng
Yangfei Yi
Zhenqi Song
Junjie Lu
Qingfeng Zhou
Jie Wen
Sheng Xiao
Yufei Li
author_facet Siyin Feng
Yangfei Yi
Zhenqi Song
Junjie Lu
Qingfeng Zhou
Jie Wen
Sheng Xiao
Yufei Li
author_sort Siyin Feng
collection DOAJ
description Abstract The forearm function in children is influenced by several factors, with the length relationship between the ulna and radius being particularly important. However, due to the underdevelopment of cartilage in children, assessing this length relationship through imaging techniques is challenging. This study aims to identify a reliable method for evaluating the lengths of the ulna and radius in children, establish normal values for the ratio of the epiphyseal plate lengths of these bones, examine this ratio in children with Monteggia fractures, and investigate its role in determining forearm function in the pediatric population. This multicenter study involved 432 normal children under 15 years of age as controls. A retrospective analysis was conducted on anteroposterior and lateral radiographs from 58 children with Monteggia fractures after surgery. The correlation between the inner-epiphysis ulna-radius length ratio, postoperative Mayo elbow joint function score, and radiographic reduction quality of the brachioradial joint was analyzed. The mean inner-epiphysis ulna-radius length ratio was 1.094, with a standard deviation of 0.024. The maximum value ranged from 1.0336 to 1.168. The medical reference range, with a 95% confidence level, was calculated as 1.047 to 1.141. In children with Monteggia fractures, the postoperative inner-epiphysis ulna-radius length ratio showed significant correlations (P < 0.05) with postoperative imaging reduction quality, as well as the range of pronation, supination, flexion, and extension, and the Mayo elbow score. In normal children, the inner-epiphysis ulna-radius length ratio ranges from 1.0336 to 1.168, with a medical reference range of 1.047 to 1.141 at a 95% confidence level. Restoring this ratio (1.047–1.141) in children with Monteggia fractures can improve elbow function and radiographic radiocapitellar joint reduction quality.
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spelling doaj-art-ab64de78b895498ab9885bc2cc0dc9e62025-08-20T02:43:15ZengNature PortfolioScientific Reports2045-23222025-02-011511910.1038/s41598-025-89751-1Correlation between inner epiphysis ulna radius length ratio and prognosis of Monteggia fractures in children: a multicenter studySiyin Feng0Yangfei Yi1Zhenqi Song2Junjie Lu3Qingfeng Zhou4Jie Wen5Sheng Xiao6Yufei Li7Department of Orthopedics, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal UniversityDepartment of Anatomy, Hunan Normal University school of MedicineDepartment of Orthopedics, People’s Hospital of Ningxiang CityPeople’s Hospital of Dongan CityPeople’s Hospital of Yuanling CityDepartment of Orthopedics, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal UniversityDepartment of Orthopedics, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal UniversityDepartment of Anatomy, Hunan Normal University school of MedicineAbstract The forearm function in children is influenced by several factors, with the length relationship between the ulna and radius being particularly important. However, due to the underdevelopment of cartilage in children, assessing this length relationship through imaging techniques is challenging. This study aims to identify a reliable method for evaluating the lengths of the ulna and radius in children, establish normal values for the ratio of the epiphyseal plate lengths of these bones, examine this ratio in children with Monteggia fractures, and investigate its role in determining forearm function in the pediatric population. This multicenter study involved 432 normal children under 15 years of age as controls. A retrospective analysis was conducted on anteroposterior and lateral radiographs from 58 children with Monteggia fractures after surgery. The correlation between the inner-epiphysis ulna-radius length ratio, postoperative Mayo elbow joint function score, and radiographic reduction quality of the brachioradial joint was analyzed. The mean inner-epiphysis ulna-radius length ratio was 1.094, with a standard deviation of 0.024. The maximum value ranged from 1.0336 to 1.168. The medical reference range, with a 95% confidence level, was calculated as 1.047 to 1.141. In children with Monteggia fractures, the postoperative inner-epiphysis ulna-radius length ratio showed significant correlations (P < 0.05) with postoperative imaging reduction quality, as well as the range of pronation, supination, flexion, and extension, and the Mayo elbow score. In normal children, the inner-epiphysis ulna-radius length ratio ranges from 1.0336 to 1.168, with a medical reference range of 1.047 to 1.141 at a 95% confidence level. Restoring this ratio (1.047–1.141) in children with Monteggia fractures can improve elbow function and radiographic radiocapitellar joint reduction quality.https://doi.org/10.1038/s41598-025-89751-1Acute Monteggia fractureChronic monteggia fractureInner-epiphysis ulna-radius length ratioElbow functionMayo score
spellingShingle Siyin Feng
Yangfei Yi
Zhenqi Song
Junjie Lu
Qingfeng Zhou
Jie Wen
Sheng Xiao
Yufei Li
Correlation between inner epiphysis ulna radius length ratio and prognosis of Monteggia fractures in children: a multicenter study
Scientific Reports
Acute Monteggia fracture
Chronic monteggia fracture
Inner-epiphysis ulna-radius length ratio
Elbow function
Mayo score
title Correlation between inner epiphysis ulna radius length ratio and prognosis of Monteggia fractures in children: a multicenter study
title_full Correlation between inner epiphysis ulna radius length ratio and prognosis of Monteggia fractures in children: a multicenter study
title_fullStr Correlation between inner epiphysis ulna radius length ratio and prognosis of Monteggia fractures in children: a multicenter study
title_full_unstemmed Correlation between inner epiphysis ulna radius length ratio and prognosis of Monteggia fractures in children: a multicenter study
title_short Correlation between inner epiphysis ulna radius length ratio and prognosis of Monteggia fractures in children: a multicenter study
title_sort correlation between inner epiphysis ulna radius length ratio and prognosis of monteggia fractures in children a multicenter study
topic Acute Monteggia fracture
Chronic monteggia fracture
Inner-epiphysis ulna-radius length ratio
Elbow function
Mayo score
url https://doi.org/10.1038/s41598-025-89751-1
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