FRACTURE MONTEGGIA PDF
All Monteggia fracture-dislocations require an urgent orthopedic assessment. Reduction is always required. Delayed or missed diagnosis is the most frequent. Monteggia fractures account for approximately 1% to 2% of all forearm fractures. Distal forearm fractures are far more frequent than midshaft. Monteggia fracture-dislocations consist of a fracture of the ulnar shaft with concomitant dislocation of the radial head. The ulnar fracture is usually obvious.
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Support Radiopaedia and see fewer ads. However, there is a wide range of potentially associated pathology that must be identified, treated, and recognized that has prognostic implications. In adults, operative treatment is usually performed under regional blockade and general anesthesia. Comminuted or long oblique ulna fractures are fixed by ORIF using plates and screws.
Epub Dec 8. Pediatric diaphyseal ulna fracture, length stable Most of these fractures will be treatable non-operatively. A full neurologic, vascular and compartment exam should be performed before and after reduction. The authors advocate early recognition and low threshold for operative fixation of complete fractures.
Please login to add comment. The direction of radial head dislocation depends on whether abduction or adduction forces were applied during the fall 1. Case 3 Case 3. Classification System InDr. Review Monteggia fracture dislocations: Difficulty in management and outcomes increases with Babo type 2 fractures and when associated with other frscture fractures radial head and coronoid process fractures.
Contributed frqcture Neal Johnson, MD. Monteggia fractures most commonly result from a direct blow to the forearm with the elbow extended and forearm in hyperpronation.
Monteggia Fracture – Pediatric – Pediatrics – Orthobullets
Plate removal should be considered in the pediatric population once fracture healing is mature. Proximal Supracondylar Holstein—Lewis fracture.
Additionally very proximal ulnar fractures, as is often seen in the lateral Bado 3, may be very difficult to hold reduced by closed means. It should be noted that injury patterns vary with mechanism vector and energy as well as patient bone quality. Log in Sign up.
J Bone Montrggia Surg Am. This video describe the clinical presentation and XR findings in Monteggia fract Adult anterior and lateral fractures The ulna is approached first through a midline posterior incision extended along its subcutaneous border. This fracture should be treated with a closed reduction and splinted with the elbow flexed at approximately degrees in full supination for 6 weeks.
What do they look like on x-ray? Osteoporosis must be taken into account when treating adult fractures. Care should be taken to stay anterior to and preserve the lateral collateral ligament.
Type I fractures are usually a result of a fall on an outstretched hand with hyperpronation or hyperextension vracture the forearm. This is usually performed in theatre under a general anaesthetic.
Three current XRays are shown. The arc of the radial head articular surface will be well visualized and should be concentric with the capitellum. The annular ligament is frequently interposed between the radial head and capitellum.