| Monteggia Fracture-Dislocation | |
|---|---|
| Classification and external resources | |
X-ray of Monteggia fracture of right forearm |
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| ICD-10 | S52.0 |
| ICD-9 | 813.03, 813.13 |
| eMedicine | orthoped/201 |
| MeSH | D009011 |
The Monteggia fracture is a fracture of the ulna that affects the joint with the radius. More precisely, it is a fracture of the proximal third of the ulna with dislocation of the head of the radius. It is named after Giovanni Battista Monteggia.[1][2]
Contents |
Mechanisms include:
There are four types (depending upon displacement of the radial head)[3]:
Monteggia fractures may be managed conservatively in children with closed reduction (resetting and casting), but due to high risk of displacement causing malunion, open reduction internal fixation is typically performed.[4]
In children, the results of early treatment are quite good, typically normal or nearly so. If diagnosis is delayed, reconstructive type surgery is needed and complications are much more common and results poorer. In adults, the healing is slower and results usually not as good.
Complications of ORIF surgery for Monteggia fractures can include non-union, malunion, nerve palsy and damage, muscle damage, arthritis, tendonitis, infection, stiffness and loss of range of motion, compartment syndrome, audible popping or snapping, deformity, and chronic pain associated with surgical hardware such as pins, screws, and plates. Several surgeries may be needed to correct this type of fracture as it is almost always a very complex fracture that requires a skilled orthopedic surgeon, usually a 'specialist', familiar with this type of injury.[5]
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