Monteggia fracture-dislocation - type 1

Case contributed by Dr Yair Glick

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.

Fluoroscopy

Intraoperative 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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Case information

rID: 67462
Published: 7th Apr 2019
Last edited: 7th Apr 2019
Inclusion in quiz mode: Included
Institution: Laniado Hospital

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