All Monteggia fracture-dislocations require an urgent orthopedic assessment. Reduction is always required. Delayed or missed diagnosis is the most frequent. Monteggia fractures account for approximately 1% to 2% of all forearm fractures. Distal forearm fractures are far more frequent than midshaft. Monteggia fracture-dislocations consist of a fracture of the ulnar shaft with concomitant dislocation of the radial head. The ulnar fracture is usually obvious.

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However, the vast majority of pediatric Monteggia fractures are treated closed with good results, and radiocapitellar reduction is usually maintained along with ulnar reduction.

Surgical goals include anatomic repair of the ulno-humeral articulation as well as the radiocapitellar joint. Log in Sign up. The energy from the ulnar fracture gets transmitted along the interosseous membrane leading to rupture of montefgia proximal quadrate and annular ligaments, disrupting the radiocapitellar joint.

Monteggia Fractures

Reduction should be maintained through flexion, extension, pronation and supination. Articles Cases Courses Quiz.

Delayed or missed diagnosis is the most frequent complication. To identify this injury, it is essential to have x-rays that include both the elbow and forearm.

What follow-up is required?

What management should be offered? Fractuee Jones March Calcaneal. If the annular ligament is trapped within the joint, reduction may be unobtainable. Maisonneuve fracture Le Fort fracture of ankle Bosworth fracture.

Forty-seven patients with Monteggia variants were followed for a mean of 8.

In children, the results of early treatment are always good, typically normal or nearly so. A small incision is made montdggia the olecranon tip fdacture line with the medullary canal. Improperly treated, these lead to severe disability related to loss of elbow and forearm range of motion. Vigilant weekly radiographic follow-up after reduction is required for early identification of a redislocated radial head. Clear Turn Off Turn On.


Additionally, placing it in an antegrade fashion through the capitellum, the joint and out the far radial neck cortex will allow for its removal in the event of breakage. Thank you for updating your details.

Monteggia fracture-dislocations – Fracture clinics. L7 – years in practice. Additionally very proximal ulnar fractures, as is often seen in the lateral Bado 3, may be very difficult to hold reduced by closed means. Closed reduction and immobilization of the arm in degrees of flexion as swelling allows and full supination enhances the stability of the injury by which of the following: Getting through the night.

Treating these difficult injuries requires knowledge of the treatment algorithms, surgical techniques and implants, and appropriate post-operative monteggix to treat these individual components in order to achieve the best results.

Cancer Therapy Advisor Daily Update. This should be arranged by the consulting orthopaedic team after their reduction and stabilisation of the injury. Technological advances in radiography and fracture research have helped to better define, classify, and guide operative management. Three current XRays are shown. In adults, the healing is slower and results usually not as good.

Monteggia fracture – Wikipedia

By registering you consent to the collection and use of your information to provide the products and services you have requested from us and as described in our privacy policy and terms and conditions. An additional oblique view may help better classify the injury. Fracture extending to distal half of ulna. The patient is right hand dominant and this is a left-sided injury. Similar articles in PubMed. The threshold for replacement instead of reconstruction should be even lower in the setting of an adult Monteggia fracture dislocation than in an isolated radial head or neck fracture because of the rfacture of an intact radial column for stability through early fractrue of motion Figure 5Figure 6Figure 7.


Monteggia fracture dislocation Monteggia fracture. It mongeggia be straight, not bowed. Bado 2 fractures had fracturr results secondary to ulnar malunion, synostosis, and problems related to concomitant coronoid or radial head fractures. Type I fractures are usually a result of a fall on an outstretched hand with hyperpronation or hyperextension of the forearm.

Monteggia Fracture – Pediatric

Originally described by Giovanni Battista Monteggia inthe Monteggia fracture montevgia a fracture of the proximal ulna associated with a dislocation of the radial head.

As is usually the case, in everyday practice, describing the fracture-dislocation is far more important than remembering the grade. In the case of a difficult reduction, particularly in the subacute situation, a small incision over the subcutaneous border of the ulna at the fracture site will allow montegggia removal and direct reduction. Examination of the proximal and distal joint should be performed to identify concomitant injuries.

Bobby Chhabra, Elliot P. As breakage is common, the pin should be stout, and protected with a long-arm cast.

Monteggia Fractures – Trauma – Orthobullets

Core Tested Community All. They may eventually present as chronic radial head dislocations with ulna malunion and require technically difficult corrective osteotomy and annular ligament reconstruction. Care should be taken to stay anterior to and preserve the lateral collateral ligament. Incomplete ulnar fracture with lateral radial head dislocation that is successfully reduced.

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