Monteggia Equivalent Variant Type 1 in an Adult, its Management and Functional Outcome with Literature Review

In 1814, Giovanni Battista Monteggia first described the fracture pattern which was further characterized by Luis Bado in 1967. Bado also coined the term Monteggia equivalent which includes a spectrum of complex fracture patterns and dislocations of the proximal ulna and radius. Monteggia equivalent lesions in adults are rare with different injury mechanisms compared to children, and thus having different management procedures.

We report a Type 1 Monteggia equivalent variant in a 31-year-old female who presented with a proximal ulnar fracture along with an ipsilateral radial neck fracture extending into the radial head. A fracture pattern that has not been reported much in literature as per our observations and we suggest should be considered a Monteggia equivalent Type 1b. Osteosynthesis of the ulna and proximal radius was done and at 1-year follow-up, complete radiological union with near-native function was achieved.

Early recognition of such complex fracture patterns and a reconstruction of the proximal radius wherever possible gives a better outcome than arthroplasty or excision as per literature.