J Korean Fract Soc.
1994 May;7(1):29-36.
Clinical Study on Monteggia fracture in Adults
- Affiliations
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- 1Department of Orthopedic Surgery, SungAe General Hospital, Seoul, Korea.
Abstract
- In 1814, Monteggia first desHribed a fracture of proximal third of the ulna with dislocation of radial head, and Bado classified and included all fracture of ulna at any level with a dislocation of radial head under the name of Monteggla lesion In 1967. In adults, the prognosis Is poor due to many complications such as nerve injury, unreduced radial head, heterotrophic ossification, nonunion and malunion. The most important factors In achieving good results in adult Monteggia lesions are early accurate diagnosis, rigid internal fixation of the ulna and complete reduction of the radial head as soon as possible. The authors reviewed 12 cases of Monteggia fracture In adults who were treatod at department of orthopaedic surgery, Sung-Ae General hospital from 1989 jan. to 1991 Dec. with 17 months mean follow-up. The results obtained were as follows: 1. Male was 10 cases and female 2 cases. 2. The causes of injury were traffic accident In 9 cases, machinery injury in 2, fall down in 1 3. Location of ulna fracture was as follows; metaphysis was 4, proximal 1/3 in 6 cases, proximal 1/3 junction in 1, metaphysls and proximal 1/3 in 1. 4. According to Bado classificatlon, type I was 58%. type II 25%, tyre III 17%, type IV 0%. 5. Treatments of dislocated radial head were closed reduction in 9 Gases open reduction in 1 case, and excision in 2 cases. 6. Fractures of ulna were all treated with open reduction and internal fixation with plate in 9 cases. IM nailing in 1 case, tension band wiring in 2 cases. 7. Palsy of posterior interosseous nerve was in 2 cases with complete recovery within 6 months. 8. The results(Bruce, et. at) 17 month follow-up in average were 2 excellent, 5 good, 2 fair and 3 poor.
