FX DE MONTEGGIA PDF
Monteggia fracture-dislocations consist of a fracture of the ulnar shaft with concomitant dislocation of the radial head. The ulnar fracture is usually obvious. Monteggia appreciated that the ulna fracture was linked to the radial head the term Monteggia fracture-dislocation in in his publication Thesis de Paris. Monteggia described a fracture of the proximal third of the ulna with . Reynders P, De Groote W, Rondia J, Govaerts K, Stoffelen D, Broos PL.
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Operative fixation of Monteggia fractures in children. The posterior Monteggia lesion.
It promotes stability of the radial head dislocation and allows very early mobilisation to prevent stiffness. Montggia page was last edited on 27 Octoberat L7 – years in practice. When is reduction non-operative and operative required? Anterior dislocation of the radial head with fracture of the shaft diaphysis of the ulna and radius. In the current period and onwardsbetter results have been obtained as a result of prompt recognition of the injury and improved plate fixation techniques that have allowed anatomic reduction of the ulna and restoration of normal contour of the trochlear notch.
Clinical Practice Guidelines : Monteggia fracture-dislocations – Emergency Department
Although the eponym Monteggia fracture-dislocation is well recognized by orthopedic surgeons, little is known about the lives and contributions of Monteggia and Bado and the evolution of treatment of this complex injury. Monteggia injuries in children.
Barquet A, Moonteggia J.
X-rays showing a Monteggia fracture of a young man left and his 1 year-postoperative radiograph following open reduction and fixation of the ulna shaft fracture by a vitallium plate and a fascial sling to maintain the reduction of the head of fxx radius.
There is plastic deformation of the ulna. Letts classification Description A Figure 7A Anterior bend of the ulnar shaft with anterior dislocation of the radial head Plastic deformation B Figure 7B Greenstick fracture of the ulnar shafyt with anterior dislocation of the radial head C Figure 7C Anterior complete fracture of the ulnar shaft with anterior dislocation of the radial head D Figure 7D Fracture of the ulnar shaft with posterior dislocation of the radial head E Figure 7E Fracture of the ulnar shaft with lateral dislocation of the radial head.
It will be painful to move the elbow in any plane. Monteggia appreciated that the ulna fracture was linked to the radial head dislocation and that both needed to be addressed simultaneously. Pan Afr Med J. Note replacement of radial head with radial head prothesis that achieved adequate articulation at the radiocapitellar joint. In a chronic context, revising the ulnar osteosynthesis is not enough is most of the case and open reduction and repairing the annular ligament are often required [ 1 ].
Rib fracture Sternal fracture. According to Reynders et al [ 3 ], open reduction of the radial head with reconstruction of the annular ligament could be responsible of a proximal synostosis between radius and ulna.
The Monteggia fracture in adults always requires a surgical treatment [ 2 ]. During the operation and in the later follow-up, careful clinical and radiological evaluation of the elbow is necessary in order to recognize residual instability of the RC joint.
Abstract Monteggia described a fracture of the proximal third of the ulna with anterior dislocation of the radial head from both the proximal radioulnar fxx radiocapitellar joints. In one case, Cunningham used a bone graft to achieve a bony union in a patient who appeared to have malunion of the ulna fracture resulting from a delayed presentation Fig. Please login to add comment.
For adults with acute injury, they advocated the use of an open reduction and fixation of the ulna fracture using vitallium plates and reduction of dislocated radial head through a single lateral incision Fig.
This was in addition to their previous publication in Speed and Boyd and raised their total experience with the treatment of Monteggia fracture-dislocations to cases.
Bado single handedly brought the practice of orthopedic surgery to Uruguay and across South America. Which direction is the radial head most likely dislocated?
There was also an increased awareness of the mechanism of the injury and variations of the original injury, namely the Monteggia lesion and its equivalents.
Several surgeries may be needed to correct this type of fracture as it is almost always a very complex fracture that requires a skilled orthopedic surgeon, usually a ‘specialist’, familiar with this montegtia of injury.
The line drawn down the shaft of the radius does not pass through the centre of the capitellum asterix. The arm should be splinted and the nearest on call orthopaedic service be consulted. The posterior interosseous nerve can also be injured due to its proximity to the radial head. Edit article Share article View revision history. Shamian B, Capo JT. In adults, the healing is slower and results usually not as good. L6 – years in practice.
Along with his clinical practice Bado immersed himself into research. However there was no recurrence of ulnohumeral instability following lateral collateral ligament reconstruction. We report a case of a Monteggia fracture were open reduction of the radial head was performed. There are four types depending upon displacement of the radial fd InBruce et al. In children, the results of early treatment are always good, typically normal dee nearly so.
Monteggia Fractures – Trauma – Orthobullets
His series included motneggia patients, and he referred to a case that appeared to be one of the earliest descriptions of a known chronic injury. Lisfranc Jones March Calcaneal. ORIF of ulnar shaft fracture approach lateral decubitus position with arm over padded support midline posterior incision placed lateral to tip of olecranon develop interval between flexor carpi ulnaris and anconeus along ulnar border proximally, and interval between FCU and ECU distally techniques with proper alignment of ulna radial head usually reduces and open reduction of radial head is rarely needed failure to align ulna will lead to chronic dislocation of radial head ORIF of radial head approach posterolateral Kocher approach technique annular ligament often found interposed in radiohumeral joint preventing anatomic reduction after ulnar ORIF treatment based on involved components radial head, coronoid, LCL.