Monteggia-like lesions in adults: our experience over the past years

Monteggia-like lesions represent a rare and complex injury with diverse fracture configurations.

To assess short- to mid-term outcomes of patients with Monteggia-like lesions treated surgically at our institution. To analyze the results based on fracture type and surgical experience.

A single-center retrospective study including 33 patients surgically treated between 2017 and 2024 was conducted. Fractures were classified using Bado, Jupiter, Mason and Regan-Morrey systems. Clinical, surgical, and functional parameters were evaluated, including complication and reoperation rates.

Mean age was 58.7years; 63.3% were female. Average joint range of motion: flexion 130.76°, extension -14.55°, pronation 80.48°, supination 82.82°. Average functional scores: MEPS 81.97, Oxford 42.73, VAS 2.4. Arthrolysis combined with prosthetic explantation was performed in 23.1% of radial head arthroplasties. Complication rate was 21.2%. No significant differences were observed based on fracture type/pattern. Outcomes were significantly better in cases managed by experienced elbow surgeons.

Further studies are required to define this entity independently from the classical lesion. The results of the present study suggest that a comprehensive management of all associated injuries, performed by experienced teams, could be associated with favorable clinical outcomes.