Acta Chir Orthop Traumatol Cech. 2010; 77(6):457-462 | DOI: 10.55095/achot2010/076

Monteggia Fractures in AdultsCurrent concepts review

H. C. FAYAZ*, J. B. JUPITER
Hand and Upper Extremity Service, Massachusetts General Hospital, Orthopaedic Surgery Harvard Medical School, Boston, Massachusetts, USA

Over the past fifty years, treatment outcomes of traumatic injuries in the upper limb have improved with the advent of better implants. However, the Monteggia fracture is often still associated with various complications, poor functional outcomes and a relatively high rate of revision surgeries. Rigid anatomic fixation of ulnar fracture is paramount. Open relocation of the radial head and soft tissue procedures are redundant.
Monteggia fractures are challenging to treat. Critical analysis with respect to the high rate of complications and unsatisfactory functional outcomes is required. The type of fracture and associated injuries such as coronoid fracture and radial head fracture appear to influence the outcome in most cases. Negative prognostic factors such as prolonged immobilization, associated coronoid and radial head fractures must be minimized and treated appropriately. Prior to surgery the patient should be informed regarding the possible risk of residual functional limitations and the potential need for further revision surgeries.

Published: December 1, 2010  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
FAYAZ HC, JUPITER JB. Monteggia Fractures in Adults. Acta Chir Orthop Traumatol Cech. 2010;77(6):457-462. doi: 10.55095/achot2010/076. PubMed PMID: 21223824.
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. AF EKENSSTAM, F. W., PALMER, A. K., GLISSON, R. R.: The load on the radius and ulna in different positions of the wrist and forearm. A cadaver study. Acta orthop. scand., 55: 363-5, 1948. Go to original source... Go to PubMed...
    2. AN, K. N., HUI, F., MORREY, B., LINSCHEID, R. et al.: Muscles across the elbow joint: a biomechanical analysis. J. Biomechanics,14: 659-669, 1981. Go to original source... Go to PubMed...
    3. BADO, J. L.: The Monteggia lesion. Clin. Orthop., 50: 71-86, 1967. Go to original source...
    4. BOYD, H. B., BOALS, J. C.: The Monteggia fracture: a review of 159 cases. Clin. Orthop., 66: 94-100, 1969. Go to original source...
    5. CHAO, E., MORREY, B.: Three-dimensional rotation of the elbow. J. Biomechanics, 11, 57-73, 1978. Go to original source... Go to PubMed...
    6. CHLOROS, G. D., WIESLER, E. R., STABILE, K. J. et al.: Reconstruction of essex-lopresti injury of the forearm: technical note. J. Hand Surg., 33-A: 124-30, 2008. Go to original source... Go to PubMed...
    7. EATHIRAJU, S., MUDGAL, C. S, JUPITER, J. B.: Monteggia fracture-dislocations. Hand Clin., 23:165-77, 2007. Go to original source... Go to PubMed...
    8. EGOL, K. A., TEJAWANI, N. C., BAZZI, J. et al.: Does a Monteggia variant lesion result in a poor functional outcome?; a retrospective study. Clin. Orthop., 438: 233-8, 2005. Go to original source... Go to PubMed...
    9. GIVON, U., PRITISCH, M., LEVY, O. et al.: Monteggia and equivalent lesions: a study of 41 cases. Clin. Orthop., 337: 208-215, 1997. Go to original source... Go to PubMed...
    10. HULTEN, O.: Ueber anatomische Variationen der Handgelenk knochen. Acta orthop. scand., 9: 155-196, 1928. Go to original source...
    11. JEPEGNANAM, T. S.: Salvage of the radial head in chronic adult Monteggia fractures. Report of four cases. J. Bone Jt Surg., 88: 645-8, 2006. Go to original source... Go to PubMed...
    12. JUPITER, J. B.: AO Manual of Fracture Management: Elbow and Forearm. In: Jupiter, JB (ed): Radius and Ulna. Shaft Davos, Switzerland, Thieme, 483-488, 2009.
    13. JUPITER, J. B., LEIBOVICL, S. J., RIBBANS, W., WILK, R. M.: The posterior Monteggia lesion. J. Orthop. Trauma, 5: 395-402, 1991. Go to original source... Go to PubMed...
    14. KLEINERT, M. T., ILYAS, A. M., JUPITER, J. B.: Radial head arthroplasty. Acta chir. orthop. Traum. čech., 77: 7-12, 2010. Go to original source...
    15. KONRAD, G. G., KUNDEL, K., KREUZ, P. C., OBERST, M., SUDKAMP, N. P.: Monteggia fractures in adults: long-term results and prognostic factors. J. Bone Jt Surg., 89: 354-60, 2007. Go to original source... Go to PubMed...
    16. Mc LAUGHLIN, H. L.: Trauma. Philadelphia, W. B. Saunders 1959.
    17. MOBLEY, J. E., JANES, J. M.: Monteggia fractures. proc. Staff Meet Mayo Clin., 2; 30: 497-504, 1955.
    18. MORI, K.: Experimental study on rotation of the forearm-functional anatomy of the interosseous ligament. J. Jap. Orthop. Ass., 59: 611-622, 1985.
    19. MORREY, B. F., AN, K. N., STORMONT, T. J.: Force transmission through the radial head J. Bone Jt Surg., 70: 250-6, 1988. Go to original source...
    20. MORRIS, A. H.: Irreducible Monteggia fracture with radial-nerve entrapment: a case report. J. Bone Jt Surg., 56-A: 1744-746, 1974. Go to original source...
    21. MUELLER, M. E.: The comprehensive classification of fractures of long bones. In: Mueller, M. E. (ed). Berlin, Springer-Verlag 1990.
    22. PAVEL, A., PITMAN, J. M., LANCE, E. M., WADE, P. A.: The posterior Monteggia fracture; a clinical study. J. Trauma, 5: 185-99, 1965. Go to original source... Go to PubMed...
    23. PENROSE, J. H.: The Monteggia fracture with posterior dislocation of the radial head. J. Bone Jt Surg., 33-B: 65-73, 1951. Go to original source... Go to PubMed...
    24. RECKLING, F. H.: Unstable fracture dislocations of the forearm (Monteggia and Galeazzi lesions). J. Bone Jt Surg., 64-A: 857-63, 1982. Go to original source...
    25. REYNDERS, P., De GROOTE W. RONDIA J. et al.: Monteggia lesions in adults: a multicenter Bota study. Acta orthop. belg., 62 (suppl. 1): 78-83, 1996. Go to PubMed...
    26. RING, D., JUPITER, J. B., WATERS, P. M.: Monteggia fractures in children and adults. J. Amer. Acad. Orthop. Surg., 6: 215-24, 1998. Go to original source... Go to PubMed...
    27. SPEED, J. S., BOYD, H. B.: Treatment of fractures of ulna with dislocation of head of radius. JAMA, 115: 1699-1705, 1940. Go to original source...
    28. THEODOROU, S. D., IERODIACONOU, M. N., ROUSSIS, N.: Fracture of the upper end of the ulna associated with dislocation of the head of the radius in children. Clin. Orthop., 228: 240-249, 1988. Go to original source...
    29. WATSON-JONE, R.: Fractures and Joint Injuries, 3rd (ed). Baltimore, Williams & Wilkins 1943, vol 2, p. 520.
    30. WEI, S. Y., BORN, C. T., ABENE, A., ONG, A., HAYDA, R., DeLONG, W. G. Jr.: Diaphyseal forearm fractures treated with and without bone graft. J. Trauma, 46: 1045-8, 1999. Go to original source... Go to PubMed...
    31. WRIGHT, R. R., SCHMELING, G. J., SCHWAB, J. P.: The necessity of acute bone grafting in diaphyseal forearm fractures: a retrospective review. J. Orthop. Trauma, 11: 288-94, 1997. Go to original source... Go to PubMed...

    Return to the content