Neglected Monteggia fracture: a review

Area of Science:

• Orthopedic Surgery
• Traumatology
• Radiology

Background:

• Monteggia fractures involve radial head dislocation and proximal ulnar fracture.
• Delayed diagnosis can lead to neglected fractures, causing forearm deformities and dysfunction.
• Untreated radial head dislocation results in humeroradial joint issues like cubitus valgus and osteoarthritis.

Purpose of the Study:

• To review the diagnosis and management of Monteggia fractures.
• To highlight the importance of early radiographic assessment in forearm injuries.
• To discuss surgical techniques for chronic radial head dislocation and associated joint instability.

Main Methods:

• Review of literature on Monteggia fracture diagnosis and treatment.
• Analysis of surgical outcomes for proximal ulnar osteotomy and open radial head reduction.
• Evaluation of supplementary procedures for humeroradial joint stabilization.

Main Results:

• Proximal ulnar osteotomy with open reduction of chronic radial head dislocation yields satisfactory functional outcomes.
• Anatomic alignment reconstruction is crucial for successful treatment.
• Supplementary procedures like transcapitellar pinning and annular ligament repair enhance joint stability but require careful assessment.

Conclusions:

• Early and accurate diagnosis of Monteggia fractures is essential to prevent long-term complications.
• Surgical reconstruction, including osteotomy and reduction, effectively restores function in neglected cases.
• Careful consideration of supplementary procedures is necessary to optimize humeroradial joint stability and minimize risks.