[Monteggia and Monteggia-like Injuries]

Area of Science:

• Orthopedic Surgery
• Traumatology
• Radiology

Context:

• Monteggia-like lesions are complex forearm injuries.
• These injuries involve proximal ulnar fractures and radial head dislocation.
• Untreated lesions risk permanent damage, including restricted motion, osteoarthritis, and pain.

Purpose:

• To outline the diagnostic and treatment standards for Monteggia-like lesions.
• To emphasize the importance of accurate preoperative planning.
• To detail the preferred surgical management strategies.

Summary:

• Monteggia-like lesions require prompt and accurate diagnosis, with CT imaging and 3D reconstruction as the gold standard.
• Anatomical reduction and osteosynthesis, typically via a dorsal approach using plate fixation, is the treatment of choice.
• Associated radial head/coronoid fractures and ligamentous injuries necessitate specific attention during treatment.

Impact:

• Adequate diagnosis and treatment are essential for optimal postoperative outcomes.
• Effective management can prevent persistent morbidity such as joint stiffness and chronic pain.
• This approach aims to restore forearm function and minimize the risk of degenerative joint disease.