Monteggia Fracture Dislocation

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.

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

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

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.

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.

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.

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.