Monteggia fracture

Monteggia fracture
Monteggia Fracture-Dislocation
Classification and external resources
X-ray of right forearm showing ulnar fracture and radial dislocation
X-ray of Monteggia fracture of right forearm
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

Causes

Mechanisms include:

  • Fall on an outstretched hand with the forearm in excessive pronation (hyper-pronation injury)
  • Direct blow on back of upper forearm. In this context, Monteggia fractures are most commonly seen in defense against blunt trauma (e.g. nightstick injury).

Classification (Bado type)

There are four types (depending upon displacement of the radial head)[3]:

  • I - Extension type (60%) - ulna shaft angulates anteriorly (extends) and radial head dislocates anteriorly.
  • II - Flexion type (15%) - ulna shaft angulates posteriorly (flexes) and radial head dislocates posteriorly.
  • III - Lateral type (20%) - ulna shaft angulates laterally (bent to outside) and radial head dislocates to the side.
  • IV - Combined type (5%) - ulna shaft and radial shaft are both fractured and radial head is dislocated, typically anteriorly.

Management

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]

Results

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]

See also

References

  1. ^ Monteggia's fracture at Who Named It?
  2. ^ G. B. Monteggia. Istituzioni Chirurgiche. Vol 5. Milano, Pirotta & Maspero, 1814.
  3. ^ eMedicine: Monteggia Fracture
  4. ^ McRae, Ronald; Esser, Max (2008). Practical Fracture Treatment (5th ed.). Elsevier Health Sciences. p. 187. ISBN 9780443068768. 
  5. ^ http://orthopedics.about.com/od/brokenbones/a/forearm.htm

External links



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Look at other dictionaries:

  • Monteggia fracture — Mon·teg·gia fracture män tej ə or Mon·teg·gia s fracture tej əz n a fracture in the proximal part of the ulna with dislocation of the head of the radius Monteggia Giovanni Battista (1762 1815) Italian surgeon. Monteggia is remembered for his… …   Medical dictionary

  • Fracture de Monteggia — ● Fracture de Monteggia traumatisme de l avant bras associant une fracture du cubitus, souvent à son tiers supérieur, et une luxation du radius à l articulation du coude …   Encyclopédie Universelle

  • fracture — [ fraktyr ] n. f. • 1391; fraiture fin XIIe; lat. fractura, de frangere → fraction 1 ♦ Vx Rupture avec violence, avec effort. ⇒ bris. État de ce qui est fracturé, rompu. ⇒ cassure. Mod. Géol. Cassure de l écorce terrestre. ⇒ 2. faille; coupure.… …   Encyclopédie Universelle

  • Fracture Double — Une fracture double désigne dans le langage commun une fracture de la jambe (fracture du tibia et du péroné) ou de l avant bras (fracture du radius et du cubitus) au cours de laquelle les deux os sont brisés. La nomenclature correcte est… …   Wikipédia en Français

  • fracture — 1. To break. 2. A break, especially the breaking of a bone or cartilage. [L. fractura, a break] apophysial f. separation of apophysis from bone. articular f. a f. involving the joint …   Medical dictionary

  • Monteggia dislocation fracture — Mon·teg·gia dislocation, fracture (mon tejґə) [Giovanni Battista Monteggia, Italian surgeon, 1762–1815] see under dislocation and fracture …   Medical dictionary

  • Fracture double — Une fracture double désigne dans le langage commun une fracture de la jambe (fracture du tibia et du péroné) ou de l avant bras (fracture du radius et du cubitus) au cours de laquelle les deux os sont brisés. La nomenclature correcte est… …   Wikipédia en Français

  • Monteggia — Giovanni B., Italian surgeon, 1762–1815. See M. fracture …   Medical dictionary

  • Bone fracture — Classification and external resources Internal and external views of an arm with a compound fracture, both before and after surgery. ICD 10 …   Wikipedia

  • Giovanni Battista Monteggia — (1762 1815) was an Italian surgeon. [WhoNamedIt|doctor|1929] Monteggia fracture is named for him.References …   Wikipedia

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