Abstract
The Monteggia injury was initially described by Giovanni Monteggia as a proximal third ulnar fracture associated with a radial head dislocation. Since that time, the Monteggia fracture eponym has evolved to encompass any fracture of the ulna with a radial head dislocation. Furthermore, it is now commonly used to describe a radiocapitellar subluxation or dislocation with an associated ulnar fracture or deformation. Monteggia fractures in the pediatric population can result in excellent outcomes if recognized early and treated promptly. Reduction of the fracture or deformity of the ulna usually results in reduction of the radial head. However, the chronically dislocated radial head from delayed recognition results in a more difficult injury and treatment strategy. Multiple surgical options for chronic Monteggia injuries have been described. Unfortunately, the surgical outcomes are less reliable for chronic injuries. The treatment options for chronic Monteggia fractures are still evolving and future large clinical trials may yield more clarity. It is important to promptly recognize the Monteggia injury to avoid an unacceptable outcome.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Bado JL. The Monteggia lesion. Clin Orthop. 1967;50:71–86.
Bell Tawse A. The treatment of malunited anterior Monteggia fractures in children. J Bone Joint Surg Br Vol. 1965;47(4):718–23.
Boyd HB, Boals JC. The Monteggia lesion: a review of 159 cases. Clin Orthop. 1969;66:94–100.
Chen W. Late neuropathy in chronic dislocation of the radial head: report of two cases. Acta Orthop. 1992;63(3):343–4.
Degreef I, De Smet L. Missed radial head dislocations in children associated with ulnar deformation: treatment by open reduction and ulnar osteotomy. J Orthop Trauma. 2004;18(6):375–8.
Dormans J, Rang M. The problem of Monteggia fracture-dislocations in children. Orthop Clin North Am. 1990;21(2):251–6.
Eygendaal D, Hillen R. Open reduction and corrective ulnar osteotomy for missed radial head dislocations in children. Strategies Trauma Limb Reconstr. 2007;2(1):31–4.
Gleeson A, Beattie T. Monteggia fracture-dislocation in children. J Accid Emerg Med. 1994;11(3):192–4.
Horii E, Nakamura R, Koh S, Inagaki H, Yajima H, Nakao E. Surgical treatment for chronic radial head dislocation. J Bone Joint Surg. 2002;84(7):1183–8.
Kay RM, Skaggs DL. The pediatric Monteggia fracture. Am J Orthop (Belle Mead NJ). 1998;27(9):606–9.
Kosay C, Akcali O, Manisali M, Ozaksoy D, Ozcan C. Congenital anterior dislocation of the radial head: a case with radiographic findings identical to traumatic dislocation. Eur J Radiol. 2002;43(1):57–60.
Letts M, Locht R, Wiens J. Monteggia fracture-dislocations in children. J Bone Joint Surg Br Vol. 1985;67(5):724–7.
Li H, Cai Q, Shen P, Chen T, Zhang Z, Zhao L. Posterior interosseous nerve entrapment after Monteggia fracture-dislocation in children. Chin J Traumatol. 2013;16(3):131–5.
Lincoln TL, Mubarak SJ. “Isolated” traumatic radial-head dislocation. J Pediatr Orthop. 1994;14(4):454–7.
Nakamura K, Hirachi K, Uchiyama S, Takahara M, Minami A, Imaeda T, et al. Long-term clinical and radiographic outcomes after open reduction for missed Monteggia fracture-dislocations in children. J Bone Joint Surg. 2009;91(6):1394–404.
Olney BW, Menelaus MB. Monteggia and equivalent lesions in childhood. J Pediatr Orthop. 1989;9(2):219–23.
Rahbek O, Deutch SR, Kold S, Søjbjerg JO, Møller-Madsen B. Long-term outcome after ulnar osteotomy for missed Monteggia fracture dislocation in children. J Child Orthop. 2011;5(6):449–57.
Ring D, Waters PM. Operative fixation of Monteggia fractures in children. J Bone Joint Surg Br Vol. 1996;78:734–9.
Ring D, Jupiter JB, Waters PM. Monteggia fractures in children and adults. J Am Acad Orthop Surg. 1998;6(4):215–24.
Rodgers W, Waters PM, Hall JE. Chronic Monteggia lesions in children. Complications and results of reconstruction*. J Bone Joint Surg. 1996;78(9):1322–9.
Speed J, Boyd HB. Treatment of fractures of ulna with dislocation of head of radius. J Am Med Assoc. 1940;115(20):1699–705.
Stoll TM, Willis RB, Paterson D. Treatment of the missed Monteggia fracture in the child. J Bone Joint Surg Br Vol. 1992;74(3):436–40.
Wang MN, Chang W. Chronic posttraumatic anterior dislocation of the radial head in children: thirteen cases treated by open reduction, ulnar osteotomy, and annular ligament reconstruction through a Boyd incision. J Orthop Trauma. 2006;20(1):1–5.
Further Reading
Hui JH, Sulaiman AR, Lee H, Lam K, Lee E. Open reduction and annular ligament reconstruction with fascia of the forearm in chronic Monteggia lesions in children. J Pediatr Orthop. 2005;25(4):501–6.
Song KS, Ramnani K, Bae KC, Cho CH, Lee KJ, Son ES. Indirect reduction of the radial head in children with chronic Monteggia lesions. J Orthop Trauma. 2012;26(10):597–601.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2015 Springer Science+Business Media New York
About this entry
Cite this entry
Lattanza, L.L., Chen, S. (2015). Monteggia Fracture Dislocations. In: Abzug, J., Kozin, S., Zlotolow, D. (eds) The Pediatric Upper Extremity. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8515-5_50
Download citation
DOI: https://doi.org/10.1007/978-1-4614-8515-5_50
Received:
Accepted:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4614-8513-1
Online ISBN: 978-1-4614-8515-5
eBook Packages: MedicineReference Module Medicine