[Osteosynthesis of ulna pseudarthrosis after Monteggia equivalents]

Stable internal fixation of the ulna is often followed by nonunion if the radial head has been resected in primary treatment of monteggia equivalents. Many patients have to undergo several operations before solid union is achieved. The reason for these disappointing results is the complex instability caused by the absence of the radial head. Our experience led us to use combined osteosynthesis with both an intramedullary compressive screw and a lateral plate. Even secondary replacement of the radial head by a spacer seems to be beneficial in the avoidance of fatigue fractures which might otherwise be caused by screw tracks. Secondary resection of the radial head practically always leads to synostosis. The results of primary treatment of monteggia fracture by the form of osteosynthesis described have proved successfully.