Monteggia Fracture Dislocation

MONTEGGIA FRACTURE DISLOCATION

Q. 1

Which of the following is NOT TRUE about Eponymous fracture?

 A

Monteggia fracture is fracture of the proximal third of the ulna with radial head dislocation

 B

Galeazzi fracture is fracture of the distal third of the radius with dislocation of the distal radio-ulnar joint

 C

Colles fracture is fracture at cortico-cancellous junction of the distal end of the radius with dorsal tilt

 D

Potts fracture is a trimalleolar ankle fracture

Q. 1

Which of the following is NOT TRUE about Eponymous fracture?

 A

Monteggia fracture is fracture of the proximal third of the ulna with radial head dislocation

 B

Galeazzi fracture is fracture of the distal third of the radius with dislocation of the distal radio-ulnar joint

 C

Colles fracture is fracture at cortico-cancellous junction of the distal end of the radius with dorsal tilt

 D

Potts fracture is a trimalleolar ankle fracture

Ans. D

Explanation:

An eponym is the name of a person, whether real or fictitious, after which a particular place, tribe, era, discovery, or other item is named or thought to be named.

One who is referred to as eponymous is someone who gives his or her name to something.

“Pott’s fracture is bimalleolar fracture of ankle, trimalleolar fracture of ankle is called cotton’s fracture”
All other eponymous fractures are correctly defined.

Ref: Maheshwari 3/e, Page 2-3.


Q. 2

In Monteggia fracture, which is true about ulnar fracture and head of radius

 A

Both ulnar fracture and head of radius is displaced posteriorly

 B

Both ulnar fracture and head of radius is displaced anteriorly

 C

Ulnar fractures is posteriorly and head of radius is displaced anteriorly

 D

Ulnar fracture is anteriorly and head of radius is displaced posteriorly

Q. 2

In Monteggia fracture, which is true about ulnar fracture and head of radius

 A

Both ulnar fracture and head of radius is displaced posteriorly

 B

Both ulnar fracture and head of radius is displaced anteriorly

 C

Ulnar fractures is posteriorly and head of radius is displaced anteriorly

 D

Ulnar fracture is anteriorly and head of radius is displaced posteriorly

Ans. B

Explanation:

B i.e. Both ulnar fracture and head of radius is displaced anteriorly


Q. 3

Posterior interosseous nerve is injured in

 A

Posterior dislocation of elbow

 B

Monteggia fracture dislocation

 C

Reversed monteggia fracture dislocation

 D

Supracondylar fracture of humerus

Q. 3

Posterior interosseous nerve is injured in

 A

Posterior dislocation of elbow

 B

Monteggia fracture dislocation

 C

Reversed monteggia fracture dislocation

 D

Supracondylar fracture of humerus

Ans. B

Explanation:

B i.e. Montegia fracture dislocation

Monteggia Fracture Dislocation

  • Fractures between the proximal third of the ulna and the base of olecranonQ combined with an anterior dislocation of the proximal radio ulnar jointQ. – Definition by Monteggia 1814
  • Bado extended Monteggia’s original description to include- any fracture of ulna with associated dislocation of the proximal radio – ulnar (rdio – capitellar) jointQ including trans olecranon fractures in which the proximal radio – ulnar joint remains intact. (New definition) Mn: “3 M” : Monteggia – Medial bone (ulna) fracture – Mountain (upper) radio – ulnar joint dislocation.

Bado’s Classification

Type

Direction of radial

head dislocation

Direction of apex of ulnar

shaft fracture angulation

I (most

common)Q

AnteriorQ

AnteriorQ

II

Posterior

Posterior

III

Lateral

Lateral

IV

Anterior

– Fracture of both radius & ulna

Radius is fractured in

proximal third below the

biceptal groove

Treatment

–  The clue to successful treatment is to restore the length of the fractured ulna; only then can the dislocated joint be fully reduced & remain stable

In adults it means an operationQ

–    Rigid anatomical fixation by plating (DCP/LCDCP) is the method of choiceQ.

* Posterior interosseous nerve has been most commonly injured nerve in forearm fractures, particularly in association with Monteggia fracture dislocationQ.




Q. 4

True regarding Monteggia fracture is:

March 2007, March 2013 (a, b, d, f)

 A

Upper ulnar fracture & dislocated radial head

 B

Upper radial fracture & dislocated ulna

 C

Lower radial fracture & dislocated ulna

 D

Lower ulnar fracture & dislocated radius

Q. 4

True regarding Monteggia fracture is:

March 2007, March 2013 (a, b, d, f)

 A

Upper ulnar fracture & dislocated radial head

 B

Upper radial fracture & dislocated ulna

 C

Lower radial fracture & dislocated ulna

 D

Lower ulnar fracture & dislocated radius

Ans. A

Explanation:

Ans. A: Upper ulnar fracture & dislocated radial head

Monteggia fracture-dislocations are classified by the Bado system

  • Bado type I injuries are characterized by a proximal ulnar fracture with anterior dislocation of the radial head. This is due to a forceful pronation injury of the forearm and is the most common type.
  • Bado type II injuries are “reversed” Monteggia fracture-dislocation injuries.
  • Here, there is posterior angulation of the ulnar fracture site and posterior dislocation of the radial head. Bado type III and IV are rare injuries.

Q. 5

Fracture shown in the photograph below represents ? 

 A

Monteggia.

 B

Galeazzi.

 C

Essex-Lopresti.

 D

Colles.

Q. 5

Fracture shown in the photograph below represents ? 

 A

Monteggia.

 B

Galeazzi.

 C

Essex-Lopresti.

 D

Colles.

Ans. A

Explanation:

Fracture shown in the photograph above represents Monteggia fracture.

The Monteggia fracture is a fracture of the proximal third of the ulna with dislocation of the head of the radius. It is named after Giovanni Battista Monteggia.

The eponym Monteggia fracture is most precisely used to refer to a dislocation of the proximal radioulnar joint (PRUJ) in association with a forearm fracture. These injuries are relatively uncommon, accounting for fewer than 5% of all forearm fractures.


Q. 6

Identify this fracture:

 A

Colle’s Fracture

 B

Barton’s Fracture

 C

Monteggia Fracture Dislocation

 D

Galleazi Fracture Dislocation

Q. 6

Identify this fracture:

 A

Colle’s Fracture

 B

Barton’s Fracture

 C

Monteggia Fracture Dislocation

 D

Galleazi Fracture Dislocation

Ans. C

Explanation:

Ans:C.)Monteggia Fracture Dislocation

Monteggia Fracture Dislocation

  • A ‘Monteggia’ injury comprises a fracture of the ulnar shaft with dislocation of the radial head at the elbow.
  • It is caused by a fall on an out-stretched hand. It may also result from a direct blow on the back of the upper forearm.

  • TYPES
    These fall into two main categories depending upon the angulation of the ulna fracture – extension and flexion type. The extension type, is the commoner
    of the two, where the ulna fracture anteriorly (extends) and the radial head dislocates anteriorly. The flexion type is where the ulna fracture angulates posteriorly (flexes) and the radial head

    dislocates posteriorly.

 




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