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.
|Published (Last):||15 July 2013|
|PDF File Size:||11.27 Mb|
|ePub File Size:||9.62 Mb|
|Price:||Free* [*Free Regsitration Required]|
If diagnosis is delayed, reconstructive surgery is needed and complications are much more common and results poorer. Osteosynthesis open reduction and internal fixation of the ulnar shaft is considered the standard of care in adults.
Clear Turn Off Turn On. Summary The Monteggia fracture involves a fracture of the ulna with an associated disruption of the radiocapitellar joint.
The posterior ulnar border should be straight.
Maisonneuve fracture Le Fort fracture of ankle Bosworth fracture. Ring, D, Waters, P. Fracture, Monteggia Neal P. Changes fractuge the incidence occurring during the s, s and s. Ulnar deformity must be corrected.
In adults, operative treatment is usually performed under regional blockade and general anesthesia. Nabil Ebraheim General – Monteggia Fractures – Educational video describing the classification of monteggia fractures.
Monteggia fracture – Wikipedia
A radial head dislocation is evident as shown by the radiocapitellar line white line. Josten C, Freitag S. Complications related to adult Monteggia fractures include those so frequently encountered in elbow trauma.
In the adult population, rehabilitation will be predicated upon elbow stability. Monteggja X-rays are usually sufficient, frcature CT can be of value in montegia planning. Support Radiopaedia and see fewer ads. After surgery, the extremity is placed in a long-arm splint with full supination and elbow flexion around degrees for Babo types 1, 3, and 4 fractures.
However if the ulna has a greenstick fracture or ‘plastic bowing’, deformity is mild and the fracture can be easily missed.
The energy from the ulnar fracture gets transmitted along the interosseous membrane leading to rupture of montdggia proximal quadrate and annular ligaments, disrupting the radiocapitellar joint. The elbow joint is particularly susceptible to loss of motion. Bumper fracture Segond fracture Gosselin fracture Toddler’s fracture Pilon fracture Plafond fracture Tillaux fracture.
Emergent orthopedic consultation is essential for open fractures and vascular compromise. Adults Operative management is crucial for the majority of adult Monteggia fractures. In most circumstances, closed reduction should be attempted.
L8 – 10 years in practice. Additional radiographs of the distal wrist and proximal elbow should be obtained with any suspicion of coexistent injury. For Babo type 2 fractures the elbow should be splinted at degrees.
Edit article Share article View revision history. J Hand Surg Am. Anterior dislocation of the radial head with fracture of the shaft diaphysis of the ulna and radius. Pre-contoured olecranon plates allow for advantageous screw positioning in more proximal fracture patterns and locking technology for osteopenic bone.
Pediatrics Children usually have better overall outcomes than adults. How common are they and how do they occur? Vigilant weekly radiographic follow-up after reduction is required for early identification of a redislocated radial head. Most pediatric Monteggia fractures can be treated via closed means. The annular ligament is frequently interposed between the radial head and capitellum. Avulsion fracture Chalkstick fracture Greenstick fracture Open fracture Pathologic fracture Spiral fracture.
Articles Cases Courses Quiz. Lisfranc Jones March Calcaneal. Trimalleolar fracture Bimalleolar fracture Pott’s fracture. Please vote below and help us build the most advanced adaptive learning platform in medicine. Summary Monteggia fracture-dislocations can be easily missed on x-ray. In other projects Wikimedia Commons.
Evaluation and Management of Monteggia Fractures
Basilar skull fracture Blowout fracture Mandibular fracture Nasal fracture Monteggiw Fort fracture of skull Zygomaticomaxillary complex fracture Zygoma fracture. Views Read Edit View history.
PA after elastic nail. In adults, the healing is slower and results usually not as good.
The goal of rehabilitation is the return of full konteggia of motion and fine motor skills with the absence of pain. Monteggia fracture-dislocation in children.