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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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J Bone Joint Surg Br.

Monteggia fracture – Wikipedia

Questions To access free multiple choice questions on this topic, click here. Getting through the night. The complexity of Monteggia fractures leads to a variety of outcomes. His radiographs are shown in figures A and B. High mechanism crush injuries warrant a detailed neurovascular exam with repeat serial exams looking for signs of acute compartment syndrome.

A radial head dislocation feacture evident as shown by the radiocapitellar line white line. HPI – Fell from her height. The fracture is fixed with AO technique with 3.

Evaluation and Management of Monteggia Fractures

He was treated with closed reduction and casting at the time of the initial injury. It promotes stability of the radial head dislocation and allows very early mobilisation to prevent stiffness.

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Open reduction of radial head dislocation with casting in supination and flexion.

If an ulna fracture is present, always look for a radial head dislocation. Case 4 Case 4. As is usually the case, in everyday practice, describing the fracture-dislocation is far more important than remembering the grade.

In the normal elbow, the central axis of the radius should pass through the center of the capitellum.

Radiographs should also include the wrist, as there may be a concomitant fracture of the distal radius, which indicates higher energy and should ffracture suspicion for compartment syndrome, or disruption of the interosseous membrane and longitudinal forearm instability. Do I need to refer to orthopaedics now? An anteroposterior and lateral view will usually identify the injury. The posterior ulnar border should be straight.

Monteggia fractures remain difficult to diagnose clinically, and debilitating complications can occur if proper management is not initiated. Since the radial head provides a degree of stability to the elbow, only very small and undisplaced fractures may be treated closed.

Monteggia Fracture – Pediatric

Potential Complications Monteggia increased awareness, pediatric Monteggia fractures are frequently missed upon initial evaluation. HPI – previous elbow injury 3 y ago treated in slab.

Reduction should be maintained through flexion, extension, pronation and frxcture. True AP and lateral fluoroscopic views should confirm an anatomic radiocapitellar line and lack of ulnar deformity. Similar articles in PubMed. They present in very much the same way as other pediatric upper extremity fractures do, with pain, deformity and limited use after fall onto an outstretched arm.


What is the most likely diagnosis? As breakage is common, the pin should be stout, and protected with a long-arm cast.

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. Fracture of the ulnar metaphysis distal to coronoid process with lateral dislocation of the radial head. monyeggia

Evaluation and Management of Monteggia Fractures – Cancer Therapy Advisor

Incomplete ulnar fracture with lateral radial head dislocation that is successfully reduced. The Royal Children’s Hospital Melbourne. Typical return to full activity in patients with low physical demands can occur after 8 to 12 weeks. How important is this topic for clinical practice?

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