Abstract
Type I Monteggia fractures are defined as proximal ulna fracture with associated anterior dislocation of the radial head (Bae, J Pediatr Orthop, 36:S67–S70, 2016; Bado, Clin Orthop Relat Res, 50(1):71–86, 1967). These injuries make up the most common Monteggia fracture type in children, but often require high clinical suspicion to prevent missed diagnosis (Monteggia, Instituzioni chirurgiches, 5:131–133, 1814). Irregular and incomplete ossification of the skeletally immature elbow limits the accurate interpretation of static radiographs. While some controversy exists as to which fracture patterns warrant surgical stabilization, operative options include elastic stable intramedullary nailing (ESIN) or open reduction and internal fixation of the ulna with secondary reduction of the radiocapitellar joint. For severe injuries, additional open reduction of the radiocapitellar joint may be necessary.
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References and Suggested Reading
Bado JL (1967) The Monteggia lesion. Clin Orthop Relat Res 50(1):71–86
Bae DS (2016) Successful strategies for managing Monteggia injuries. J Pediatr Orthop 36:S67–S70
Dormans JP, Rang M (1990) The problem of Monteggia fracture-dislocations in children. Orthop Clin North Am 21(2):251–256
Foran I, Upasani VV, Wallace CD, Britt E, Bastrom TP, Bomar JD, Pennock AT (2017) Acute pediatric Monteggia fractures: a conservative approach to stabilization. J Pediatr Orthop 37(6):e335–e341
Fowles JV, Sliman N, Kassab MT (1983) The Monteggia lesion in children. Fracture of the ulna and dislocation of the radial head. J Bone Joint Surg Am 65(9):1276–1282
Kunkel S, Cornwall R, Little K, Jain V, Mehlman C, Tamai J (2011) Limitations of the radiocapitellar line for assessment of pediatric elbow radiographs. J Pediatr Orthop 31(6):628–632
Letts M, Locht RA, Wiens JO (1985) Monteggia fracture-dislocations in children. J Bone Joint Surg 67(5):724–727
Monteggia GB (1814) Lussazioni delle ossa delle estremita superiori. Instituzioni chirurgiches 5:131–133
Ramirez RN, Ryan DD, Williams J, Wren TA, Ibrahim D, Weiss JM, Kay RM, Lightdale-Miric N, Skaggs DL (2014) A line drawn along the radial shaft misses the capitellum in 16% of radiographs of normal elbows. J Pediatr Orthop 34(8):763–767
Ramski DE, Hennrikus WP, Bae DS, Baldwin KD, Patel NM, Waters PM, Flynn JM (2015) Pediatric Monteggia fractures: a multicenter examination of treatment strategy and early clinical and radiographic results. J Pediatr Orthop 35(2):115–120
Ring D, Waters PM (1996) Operative fixation of Monteggia fractures in children. J Bone Joint Surg 78(5):734–739
Silberstein MJ, Brodeur AE, Graviss ER (1979) Some vagaries of the capitellum. J Bone Joint Surg Am 61(2):244–247
Souder CD, Roocroft JH, Edmonds EW (2017) Significance of the lateral humeral line for evaluating radiocapitellar alignment in children. J Pediatr Orthop 37(3):e150–e155
Turner RC, Ho CA (2019) Monteggia fractures: pearls and pitfalls. Oper Tech Orthop 29(1):34–42
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Stavinoha, T.J. (2020). Type I Monteggia Fractures. In: Iobst, C., Frick, S. (eds) Pediatric Orthopedic Trauma Case Atlas. Springer, Cham. https://doi.org/10.1007/978-3-319-29980-8_37
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DOI: https://doi.org/10.1007/978-3-319-29980-8_37
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