Neglected Type I Monteggia Fracture Dislocation in Adult

Neglected Monteggia fracture dislocation is one of the challenging case and it becomes more of a therapeutic dilemma especially in adults. Several surgical techniques are described and in spite of this complication rate following surgery is high. This report concerns with management of three-month-old monteggia fracture dislocation in a 30-year-old male. Patient presented with complete loss of movement at elbow. Patient was managed surgically, with internal fixation of ulna and reduction of radial head with radio-capitellar Kirschner wires. Postoperatively at six months, ulna united and patient has achieved flexion from 50 to 115 degrees at elbow and supination pronation arc of 120 degrees. We do not see any indication for procedures directed at the reconstruction of annular ligament. The dilemma remains whether radial head preservation or excision gives better functional range of motion in adult neglected monteggia fracture dislocation.