Management of Monteggia Injuries in the Adult

Hand Clin. 2020 Nov;36(4):479-484. doi: 10.1016/j.hcl.2020.07.002. Epub 2020 Sep 2.

Abstract

Monteggia fracture-dislocation of the elbow is a fracture of the proximal ulna with associated dislocation of the radial head or radial neck fracture. In adults, this injury is managed with open reduction and internal fixation of the ulna fracture. Care should be taken to ensure anatomic reduction of the proximal ulna. If radial head dislocation or subluxation persists, reduction of the ulna should be reassessed. Rarely, interposed soft tissue may block radial head reduction, and requires removal. Complications include hardware prominence, stiffness, infection, heterotopic ossification, nerve injury, malunion or nonunion of the ulna, radioulnar synostosis, and persistent radial head instability.

Keywords: Elbow dislocation; Elbow fracture; Monteggia fracture; Radial head; Ulna fracture.

Publication types

  • Review

MeSH terms

  • Adult
  • Bone Plates
  • Fracture Fixation, Internal
  • Humans
  • Monteggia's Fracture / classification
  • Monteggia's Fracture / diagnosis
  • Monteggia's Fracture / surgery*
  • Open Fracture Reduction