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Monteggia fracture-dislocation - type 1

Case contributed by Yaïr Glick
Diagnosis certain

Presentation

Fall from height.

Patient Data

Age: 30 years
Gender: Female

Comminuted ulnar fracture with butterfly fragment between the proximal and middle thirds of the diaphysis.
Anterior dislocation of the radial head.

Transverse fracture of the 1st metacarpal seen on the frontal film.

Intraoperative fluoroscopy

Fluoroscopy

The ulnar fracture was fixed with a fixation plate and screws; note that one of the screws (4th from the elbow) faces the "wrong" way because it was used to fix the butterfly fragment in place.

The radial head dislocation has been reduced.

The 1st metacarpal fracture was fixed using two Kirshner wires.

Case Discussion

This case illustrates a type I Monteggia fracture-dislocation, according to the widely used Bado classification. Of the 4 types of Monteggia fracture-dislocations, type I is the most common.

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