Murali Poduval, MBBS, MS, DNB is a member of the following medical societies: Association of Medical Consultants of Mumbai, Bombay Orthopedic Society, Indian Orthopedic Association, Indian Society of Hip and Knee SurgeonsDisclosure: Nothing to disclose. The mechanism of injury is most often a fall on an outstretched hand. The radial head dislocation may not be apparent and will possibly be missed if the elbow is not included in the radiograph. The olecranon, midshaft, and distal shaft may be involved. [QxMD MEDLINE Link]. Then divide the underlying padding with scissors (2) and remove the protective strip to expose the skin. Galeazzi fracture: Distal radial shaft fracture with associated distal radio-ulnar joint (DRUJ) dislocation Special Investigations Imaging '2 views and 2 joints': Always get a minimum of two views (AP and LAT) that include the joint above and below the injury (two joints). 2009 Jun. Share cases and questions with Physicians on Medscape consult. Forty-eight patients who had been followed for a minimum of two years (average, 6.5 years; range, two to fourteen years) were identified. The eponymous term "Monteggia fracture" is most precisely used to refer to dislocation of the proximal radioulnar joint in association with a forearm fracture. The first case is a combined type III Monteggia injury with ipsilateral Type II Salter-Harris injury of the distal end radius fracture with metaphyseal fracture of the Conclusions: Monteggia fracture dislocation equiva-lents are rare injuries and pre-surgery recognition by radio-graphs and 3-D CT helps make optimal plan. The Monteggia lesion. - hence, these patients will require close follow up; - Treatment: The fracture of the radial head was treated with either complete or partial excision of the fragments in twelve patients (with replacement with a silicone prosthesis in two), open reduction and internal fixation in ten patients, and no intervention in four patients. 1967; 50:71-86. [QxMD MEDLINE Link]. [14]. Proximal ulnar osteotomy in the treatment of neglected childhood [14] Osteoarthritic changes were seen at the radiohumeral joint in four patients. Richard L Ursone, MD Orthopedic Surgeon, Department of Orthopedics and Rehabilitation, Brooke Army Medical Center Lateral ulnar collateral ligament disruption, Anterior band of the medial collateral disruption, Posterior band of the medial collateral ligament disruption. Injury. If you log out, you will be required to enter your username and password the next time you visit. Closed reduction; cast immobilization for Monteggia lesion - AO Foundation Compartment Syndrome in Operatively Managed Pediatric Monteggia Fractures and Equivalents. A Monteggia fracture is defined as a proximal 1/3 ulna fracture with an associated radial head dislocation. [2]. (2/7), Level 4 Monteggia Fracture - Orthopedics - Medbullets Step 2/3 Towson, MD 21204 Diagnosis is made with forearm and elbow radiographs to check for congruency of the radiocapitellar joint in the setting of an ulna fracture. In a study evaluating long-term clinical and radiographic outcomes after open reduction for missed Monteggia fracture-dislocations in 22 children (14 boys, 8 girls; age range, 4 y to 15 y 11 mo), Nakamura et al noted that the postoperative Mayo Elbow Performance Index (MEPI) at follow-up ranged from 65 to 100, with 19 excellent results, two good results, one fair result, and zero poor results. Wheeless' Textbook of Orthopaedics. J Pediatr Orthop 2015; 35 (2) 115-120. PDF Monteggia fracture dislocation equivalents analysis of eighteen cases The Galeazzi fracture is a fracture of the middle to distal one-third of the radius associated with dislocation or subluxation of the distal radioulnar joint (DRUJ). Monteggia fractures account for fewer than 5% of forearm fractures, with published literature supporting figures in the range of 1-2%. The relatively good results associated with nonoperative treatment of pediatric Monteggia injuries reflect the prevalence of stable (incomplete) fractures in children. - see: nerve injuries Hume fracture - fracture of the olecranon accompanied by anterior dislocation of the radial head. 2009 Nov. 34 (9):1618-24. Are you sure you want to trigger topic in your Anconeus AI algorithm? Kevin Strohmeyer, MD Consulting Surgeon, Department of Orthopedic Surgery, Darnall Army Community Hospital, Kevin Strohmeyer, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons. Waters PM. 1951;33:65-73. - non union of frx of ulnar shaft [QxMD MEDLINE Link]. of flexion; Key words: Monteggia's fracture; Radius fracture; Ulna - angulated ulnar shaft is reduced by firm manual pressure; - Type II (flexion type) - 15%