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Monteggia Fracture Dislocation: Ulna Fixation with Radial Head Replacement

  • Evan M. Guerrero
  • Marc J. Richard
  • Mark J. GageEmail author
Chapter

Abstract

Monteggia fracture dislocations occur in various patterns. It is important to recognize radial head fractures and be prepared to perform radial head replacement in patterns that are unreconstructable. It is also important to recognize those ulna fractures which involve the coronoid process (Jupiter IIA), as these necessitate fixation of the separate coronoid fragment to achieve stability, and have worse outcomes compared to other Monteggia fractures. Keys to successfully treating Monteggia fractures requiring radial head replacement include thoughtful patient positioning, working through the ulna fracture to access the radial head when possible, and avoiding oversized components when implanting the radial head replacement.

Keywords

Monteggia Ulna fracture Radial head fracture Radial head replacement Open reduction and internal fixation Mason classification Jupiter classification Bado classification 

References

  1. 1.
    Bado JL. 7 The Monteggia Lesion. Clin Orthop Relat Res®. 1967;50:71–86.Google Scholar
  2. 2.
    Jupiter JB, Leibovic SJ, Ribbans W, Wilk RM. The posterior Monteggia lesion. J Orthop Trauma. 1991;5(4):395–402.CrossRefGoogle Scholar
  3. 3.
    Mason ML. Some observations on fractures of the head of the radius with a review of one hundred cases. Br J Surg. 1954;42(172):123–32.CrossRefGoogle Scholar
  4. 4.
    Johnston GW. A follow-up of one hundred cases of fracture of the head of the radius with a review of the literature. Ulster Med J. 1962;31(1):51.PubMedPubMedCentralGoogle Scholar
  5. 5.
    Hotchkiss RN. Displaced fractures of the radial head: internal fixation or excision? J Am Acad Orthop Surg. 1997;5(1):1–0.CrossRefGoogle Scholar
  6. 6.
    Ring D, Quintero J, Jupiter JB. Open reduction and internal fixation of fractures of the radial head. JBJS. 2002;84(10):1811–5.CrossRefGoogle Scholar
  7. 7.
    Grewal R, MacDermid JC, Faber KJ, Drosdowech DS, King GJ. Comminuted radial head fractures treated with a modular metallic radial head arthroplasty: study of outcomes. JBJS. 2006;88(10):2192–200.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Evan M. Guerrero
    • 1
  • Marc J. Richard
    • 1
  • Mark J. Gage
    • 1
    Email author
  1. 1.Department of Orthopaedic SurgeryDuke University Medical CenterDurhamUSA

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