Monteggia fracture-dislocations consist of a fracture of the ulnar shaft with concomitant dislocation of the radial head. The ulnar fracture is usually obvious. Monteggia appreciated that the ulna fracture was linked to the radial head the term Monteggia fracture-dislocation in in his publication Thesis de Paris. Monteggia described a fracture of the proximal third of the ulna with . Reynders P, De Groote W, Rondia J, Govaerts K, Stoffelen D, Broos PL.
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In children most of injuries e. Internal fixation of the fractured ulna with intramedullary steinmann pin. At age 52, Monteggia died on January 17, after experiencing fever and a skin infection that started around his ear and quickly spread over his face. Physical examination showed swelling of the elbow and upper forearm and an obvious deformity.
InBruce et al. However if the ulna has a greenstick fracture or ‘plastic bowing’, deformity is mild and the fracture can be easily missed. Operative Techniques in Orthopaedics. Fracture of the shaft of ulna and radius with associated dislocation of the radial head.
This is a classification system built off of Bados type II lesion. This is why litigation is common. When a forearm fracture is identified, dedicated imaging of both the elbow and the wrist is important and good quality AP and lateral views are essential.
An open reduction of the ulna fracture and radial head with reconstruction of the annular ligament was reserved for chronic cases. In all except Monteggia type IV injuries, Bado advocated a nonoperative approach except for resistant cases and reported satisfactory results.
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Monteggia fracture-dislocations: A Historical Review
Tuson, Shah Alam Khan. There is plastic deformation of the ulna. National Center for Biotechnology InformationU. The posterior Monteggia lesion with associated ulnohumeral instability. Once this step is properly achieved, radial head is automatically reduced in most of the cases. During this period, a number of publications discussing Monteggia fracture-dislocations appeared in the literature, which reflected an increasing awareness and experience with this injury.
Epidemiology and treatment of monteggia lesion in adults: Type IV is an anterior dislocation of the radial head with a proximal radial and ulnar shaft fracture in the same level.
His assistance is greatly appreciated. Conforti Maria, Monteggia Giovanni Battista. Monteggia fracture South Med J. Their series included 23 patients with Bado type II Monteggia fracture-dislocation, of whom 6 patients had an accompanying posterior ulnohumeral dislocation.
This is usually performed in theatre under a general anaesthetic. The latter is less common and was not described by Monteggia.
What is the best treatment? Along with his clinical practice Bado immersed himself into research. Monteggia fracture-dislocations can be easily missed on x-ray. The ulna resists rotation and fractures as a result of combination of rotation force and longitudinal compression. Discussion In Monteggia reported a particular injury pattern associating a fracture of the proximal third of the shaft of the ulna, with a dislocation of the radial head from both the superior radio-ulnar and the radio-humeral joints [ 1 – 3 ].
You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Fracture of the ulna is distal to the coronoid f, involving the metaphyseal and diaphyseal junction. Introduction The original fracture pattern described by Monteggia is a fracture of the proximal third of the ulna with anterior dislocation of the radial head.
British Journal of Surgery. Monteggia described a fracture of the proximal third of the ulna with anterior dislocation of the radial head from both the proximal radioulnar and radiocapitellar joints.
A fracture of the shaft of the ulna associated with an anterior dislocation of the radial head was described by an Italian surgeon, Giovanni Battista Monteggia, in In fresh injuries, it is generally not be necessary to approach the RC joint except in the rare cases of incarceration of soft parts annular ligament or a bone fragment fracture of the radial head. Tompkins in Wisconsin later challenged the mechanism of injury described by Evans and suggested that a soft-tissue component might be responsible for the pattern of injury observed.
Journal of Clinical Orthopaedics and Trauma. What are the potential complications associated with this injury? Monteggia used this annuity for access to a multitude of publications to support his future research. Type I fractures are usually a result of a fall on an outstretched hand with hyperpronation or hyperextension of the forearm.
Resection of the head and neck of the radius was reserved for a severely fractured radial head to avoid complications such as degenerative arthritis of the radiohumeral joint or recurrence of dislocation. Postoperative radiography in the operating room showed a good reduction of the Ulna fracture but persistent anterior dislocation of the radial head Figure 2.
In Cooper, from London, England, described anterior, posterior, and lateral dislocations of the radial head with fracture of the ulna shaft.
Traumatic pathology of antibrachial interosseous membrane of forearm. Greater disability was also noted in patients who experienced ulnohumeral dislocation when evaluated by outcome scores including the Disabilities of the Arm, Shoulder or Hand questionnaire and the functional rating index of Broberg and Morrey. Dalla Stamperia Dova; Milano, Italy: Delayed diagnosis is the most frequent complication.
To quiz yourself on this article, log in to see multiple choice questions. Abstract The eponym Monteggia fracture-dislocation originally referred to a fracture of the shaft of the ulna accompanied by anterior dislocation of the radial head that was described by Giovanni Battista Monteggia of Italy in What management should be offered? Typical fracture fs of posterior variant of Monteggia lesion as montegga by Penrose.