Monteggia Fracture-Dislocation
Classification and external resources
ICD-10	S52.0
ICD-9	813.03, 813.13
eMedicine	orthoped/201

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 the dislocation of the head of radius.

It is named for Giovanni Battista Monteggia.^[1][2]

Contents 1 Causes 2 Classification (Bado type) 3 Management 4 Results 5 See also 6 References 7 External links

[edit] Causes

• Fall on an outstretched hand with the forearm in excessive pronation (hyper-pronation injury)
• Direct blow on back of upper forearm.

[edit] Classification (Bado type)

There are four types (depending upon displacement of 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.

[edit] 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]

[edit] 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.

[edit] See also

• Galeazzi fracture
• Hume fracture

[edit] References

[edit] External links

• Monteggia and Galeazzi fractures - wheelessonline.com
• Monteggia Fracture Dislocation - gentili.net

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