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Related Experiment Videos

The posterior Monteggia lesion.

J B Jupiter1, S J Leibovic, W Ribbans

  • 1Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston.

Journal of Orthopaedic Trauma
|January 1, 1991
PubMed
Summary

This study analyzed posterior Monteggia fracture-dislocations in adults, finding surgical treatment outcomes varied. Early recognition of this specific fracture pattern is crucial for successful forearm function.

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Area of Science:

  • Orthopedic Surgery
  • Traumatology
  • Anatomy

Background:

  • Posterior Monteggia fracture-dislocations are complex injuries involving the proximal ulna and radial head.
  • This specific pattern, characterized by ulnar fractures near the coronoid and posterolateral radiocapitellar dislocation, may be underreported.

Purpose of the Study:

  • To describe the characteristic features of posterior Monteggia fracture-dislocations.
  • To evaluate the surgical treatment outcomes and functional results of these injuries.

Main Methods:

  • Retrospective review of 13 adult patients surgically treated for posterior Monteggia fracture-dislocations.
  • Surgical management included ulnar fracture fixation with plates and various treatments for radial head fractures (excision, prosthesis, ORIF).

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  • Functional outcomes assessed using the Broberg and Morrey performance index.

    • Main Results:

    • 13 patients (9 female, 4 male, average age 56) were treated.
    • 11 patients had functional outcomes rated: 3 excellent, 3 good, 4 fair, 1 poor.
    • Four cases of incomplete ulnar reduction led to subluxation and loss of supination.

    Conclusions:

    • Recognition of the specific anatomical features of this posterior Monteggia fracture-dislocation is essential for optimal surgical outcomes.
    • Incomplete reduction of the ulnar fracture can compromise forearm function, particularly supination.