Mar 26, 2020 a monteggia fracture is a fracture of the arm in which the ulna, one of the bones in the forearm, breaks, and the joint with the radial head at the elbow becomes dislocated. A big risk with an open fracture, which means that your skin has been damaged during the injury or the bone has broken through your skin, is necrosis. Monteggia fracture free download as powerpoint presentation. Monteggia fracture dislocations consist of a fracture of the ulnar shaft with concomitant dislocation of the radial head. Monteggia fractures dislocations orthopedic trauma service. For monteggia fracture dislocations, best treatment includes orif of the ulna diaphyseal fracture. Aug 06, 2018 think of the monteggia fracture as the exact opposite of a galeazzi fracture.
Monteggia fracture causes, treatment, surgery, management. The eponym monteggia fracturedislocation originally referred to a. The ulnar fracture is usually obvious, whereas the radial head dislocation can be overlooked, with potentially serious functional and medicolegal ramifications. The eponym monteggia fracture is most precisely used to refer to a dislocation of the proximal radioulnar joint in association with a forearm. Fracture of the proximal or middle third of the ulna with posterior dislocation of the radial head 70 to 80% of adult monteggia fractures. Case 1 a monthold girl olecranon fracture galeazzi monteggia about blog go ad free. Given the extent of comminution and the instability of the elbow, the patient was indicated for surgical fixation. Occupational therapy perspective on rehabilitation for. Exactly what treatment will be used depends on how severe the injury is but the conservative treatment is to put a cast on the arm in order to immobilize the arm while the joint and ulna have an opportunity to heal. It is the character of the ulnar fracture, rather than the direction of radial head dislocation, that is useful in determining the optimal treatment of monteggia fractures in both children and adults. Physical exam must palpate over radial head with all ulna fractures because spontaneous relocation of radial head is common. Anatomic reduction, rigid fixation specific attention to the contour of the ulna grechenig w, clement h, pichler w, tesch np, windisch g. The treatment of adult monteggia fracturedislocations. Jun 30, 2016 forearm fracture is seen on radiographs, both the wrist and the elbow must be evaluated to exclude associated dislocations and additional fractures.
He defined it as a traumatic lesion featuring a fracture of the proximal ulna and an anterior dislocation of the proximal epiphysis of the radius. This video demonstrates a locking plate technique for repair of a comminuted fracture of. Fracture of the proximal third of the ulna with dislocation of the radial head. Stable anatomic reduction of the ulnar fracture results in anatomic reduction of the radial head. A monteggia fracture is often managed with resetting and casting in children. Such an isolated ulnar shaft fracture is not a monteggia fracture. Jun 20, 2019 fracture monteggia pdf all monteggia fracturedislocations require an urgent orthopedic assessment. However, the monteggia fracture is often still associated with various. Pdf monteggia fracture with unreducable anterior dislocation of. Monteggia fracture pediatric pediatrics orthobullets. For monteggia fracturedislocations, best treatment includes orif of the ulna diaphyseal fracture. Monteggia fracture dislocations can be easily missed on xray.
Monteggias fracture definition of monteggias fracture by. In this context, isolated ulnar shaft fractures are most commonly seen in defence against blunt trauma e. Athletes and manual workers may require more prolonged rehabilitation. The first case is a combined type iii monteggia injury with ipsilateral type ii salterharris injury of the distal end radius fracture with metaphyseal fracture of the. What is the best treatment for monteggia fracturedislocations. Since that time, the monteggia fracture eponym has. Fracture of the proximal or middle third of the ulna with anterior dislocation of the radial head most common in children and young adults type ii. If the fracture seems to be unstable on the initial films or at the initial, internal fixation using an intramedullary pinning technique is done. The evolution of management of monteggia fracture dislocations can be considered in 3 chronological periods. There are several mnemonics for the difference between a galeazzi and a monteggia fracture dislocation. The patient is a 65yearold woman with a bado ii monteggia fracture after a lowenergy fall from standing height.
The evolution of management of monteggia fracturedislocations can be considered in 3 chronological periods. Monteggia fracture synonyms, monteggia fracture antonyms. The influence of lateral and anterior angulation of the proximal ulna on the treatment of a monteggia fracture. In the early period 18141939, the components of the monteggia injury were identified, and the importance of reducing the radial head and ulna shaft fracture became apparent. Neglected monteggia fracture was defined as presentation to the pediatric. Pdf the monteggia fracture is a rare fracture of the forearm combining stricto sensu an ulna fracture, a radiohumeral dislocation and a radioulnar. If an ulna fracture is present, always look for a radial head dislocation. Monteggia fracture dislocation is rare in children 2,3,4.
Fracture monteggia pdf all monteggia fracturedislocations require an urgent orthopedic assessment. Monteggia fracture definition of monteggia fracture by the. Symptoms pain, swelling, and deformity about the forearm and elbow. Monteggia fracturedislocation radiology reference article. Monteggia fracture pediatric orthopaedic society of. Ebraheims educational animated video describes monteggia fracture dislocation. Pronunciation of monteggia with 1 audio pronunciation and more for monteggia. Pdf over the past fifty years, treatment outcomes of traumatic injuries in the upper limb have improved with the advent of better implants. This is a report of two rare variants of monteggia fracture dislocation. Monteggia fracture dislocation everything you need to. Fracture of the proximal third of the ulna with dislocation of. Jun, 2019 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 frakktur type of injury. They typically occur in children between 4 and 10 years of age after a fall onto an outstretched hand. To access free multiple choice questions on this topic, click here.
This fracture pattern was first described in 1814 by giovanni monteggia. Monteggia fracture pictures, symptoms, causes, diagnosis. Fracture of the proximal or middle third of the ulna with anterior dislocation of the radial head most common in children and young adults. Ulnar shaft fracture associated with dislocation of radial head pruj. A simple fracture is one in which there is no contact of the broken bone with the outer air, i.
The type of fracture depends largely on the mechanism of injury evans, 1949. This fracture is usually very evident because it causes extreme pain and the patients range of motion will be limited as a result of the fracture. Grimus mugr pronounced as mugger frog gruesome murder manchester united glasgow rangers it is useful to note that it is the head of. To identify this injury, it is essential to have xrays that include both the elbow and forearm. Jan 06, 2020 there are several mnemonics for the difference between a galeazzi and a monteggia fracturedislocation. Galeazzi and monteggia fracturedislocations mnemonic.
Direct blow on back of upper forearm would be a very uncommon cause. Whereas the galeazzi is a distal radius fracture with a distal ulnar dislocation which pulls the radioulnar joint apart, the monteggia is a proximal ulnar fracture with a proximal radial head dislocation. Monteggia fracture dislocations are unstable injuries composed of a proximal ulna fracture and dislocation of the radial head. This retrospective analysis of 220 forearm fractures in children shows. This can be accomplished by using a single pin of sufficient size or multiple small pins, nesting them within the medullary canal to provide stability. Monteggia fracture synonyms, monteggia fracture pronunciation, monteggia fracture translation, english dictionary definition of monteggia fracture. Monteggia fracture elbow anatomical terms of motion. The fractured bone is switched, as is the dislocation. Comparison of treatment methods for pediatric monteggia fracture. Case example bilateral monteggia fracture dislocations.
Monteggia fracture dislocations are uncommon in childhood. Monteggia fracture dislocation everything you need to know. Monteggia fracture medical definition merriamwebster. Pdf monteggia described a fracture of the proximal third of the ulna with anterior dislocation of the radial head from. Monteggia described a fracture of the proximal third of the ulna with. In 1814 giovanni battista monteggia described two patients with a fracture of the proximal third of the ulna together with an anterior dislocation of the proximal epiphysis of the radius. Monteggia fracture definition of monteggia fracture by.