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.
Thank you for rating! The alignment and stability of the radius and ulna originate from three ligamentous structures: Please login to add comment. Monteggia fractures most commonly result from a direct blow to the forearm with the elbow extended fractyre forearm in hyperpronation. L6 – years in practice. The injury is usually a neuropraxia. Pre-contoured olecranon plates allow for advantageous screw positioning in more proximal fracture patterns and locking technology for osteopenic bone.
Evaluation and Management of Monteggia Fractures – Cancer Therapy Advisor
HPI – pai and limitation of elbow since 2 years. Pediatric length unstable ulna fractures An approach to the subcutaneous border of the ulna between the extensor carpi ulnaris ECU and flexor carpi ulnaris FCU is made. Please login to add comment. J Bone Joint Surg Am. He continued to have pain in the lateral aspect of his elbow, with an associated prominence anterolaterally. The radiocapitellar joint primarily stabilizes the proximal forearm while the TFCC predominantly supports the distal forearm.
A heavy K wire or appropriate elastic nail, just smaller than the isthmus of the ulna is then introduced through the medullary canal in an anterograde fashion to just shy of the fracture. Patients with diaphyseal forearm fractures usually complain of pain at the site of injury.
The posterior ulnar border should be straight. As is usually the case, in everyday practice, describing the fracture-dislocation is far more important than remembering the grade. Combined radius and long oblique ulnar fracture and reduced radial head dislocation.
Monteggia Fractures – Trauma – Orthobullets
Type I The proximal ulna is fractured and radial head dislocation directed anteriorly. No sponsor or advertiser has montdggia in, approved or paid for the content provided by Decision Support in Medicine LLC. Radiographic reading Radiocapitellar line: Adults are more prone to the persistent angulation and shortening despite closed reduction techniques. Associated fracthre an instability of the ulnohumeral joint and high rates of radial head fracture and posterior interosseous nerve injury.
J Hand Surg Am. Post—operative Rehabilitation Children should be placed in a well-molded long-arm cast after open or closed reduction. All Monteggia fractures are considered unstable and require intervention.
Operative management is crucial for the majority of adult Monteggia fractures. In the vast majority of both pediatric Monteggia variants, reduction of the ulna leads to spontaneous reduction of the radial head. Surgical Technique Patient set—up In adults, operative treatment is usually performed under regional blockade and general anesthesia.
Stiffness may result from prolonged immobilization. Distally, the radius connects with the scaphoid and lunate bones of the wrist. Summary The Monteggia fracture involves a fracture of the ulna with an associated disruption of the radiocapitellar joint. What follow-up is required?
These types depend on the direction of the radial head dislocation. Normal ulna with straight border red line.
Monteggia Fracture – Pediatric
In the adult population, rehabilitation will be predicated upon elbow stability. It is named after Giovanni Battista Monteggia. They may present as part of a pattern of global elbow instability such as the trans-olecranon elbow fracture-dislocation.
There are four types depending upon displacement of the radial head: Of eight patients that presented late, two had poor fracturf and secondary procedures.
A radial head dislocation is evident as shown by the frxcture line. Careful weekly radiographic follow-up, for the first 3 weeks after reduction is important ensure maintenance of reduction throughout treatment. What are the potential complications associated with this injury?
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