$monteggia fracture pronunciation$

$monteggia fracture pronunciation$

Fractures at the level of the olecranon often include associated fracture of the coronoid. What these fractures have in common is (1) an apex posterior fracture of the proximal ulna, (2) fracture of the radial head in most patients, and (3) avulsion of the lateral collateral ligament from the lateral epicondyle in most patients. The more proximal the fracture of the ulna lies, the greater the relative sparing of the proximal radioulnar relationship. The final group consists of patients with complex fractures involving several levels (type D). The diaphyseal posterior Monteggia fracture (type C) most resembles the classic anterolateral Monteggia fracture originally described however, most posterior Monteggia injuries occur at the level of the metaphysis (type B) or the olecranon (type A). They point out that posterior Monteggia injuries are not merely forearm fracture dislocations but are really transitional lesions involving aspects of traumatic instability of both the elbow and the forearm. The classification of posterior Monteggia fractures proposed by Jupiter and colleagues is useful primarily as way to conceptualize fracture variations that might otherwise seem disparate into a spectrum of injuries with similar management considerations. The idea of Monteggia equivalents is particularly confusing and I do not recommend the use of this term or classification scheme. Therefore, I have not found Bado’s classification particularly useful. It is not clear how to distinguish types 1 and 3, and type 4 seems like a subset of type 1 and 3. The traditional classification of Monteggia fractures according to direction (anterior, lateral, or posterior) was made numeric by Bado : type 1, anterior type 2, posterior type 3, lateral and type 4 with a concomitant radial diaphyseal fracture. ( E and F ) The coronoid was manipulated and reduced through the olecranon fracture the proximal ulna was secured with a dorsal, contoured plate and screws the radial head was replaced with a prosthesis and the lateral collateral ligament complex was reattached to the lateral epicondyle with a suture anchor. The fractures of the coronoid and radial head are comminuted, but there is a large coronoid facet fragment to work with. ( D ) Three-dimensional computed tomography images with and without the distal humerus are much more easily interpreted. ( C ) Two-dimensional computed tomography is helpful but difficult to interpret. Lateral and anteroposterior radiographs after injury show an apex posterior ulna fracture, a large coronoid fracture, and posterior dislocation of the radial head with fracture. ( A and B ) A 40-year-old man fell from a height. Posterior olecranon fracture-dislocation. The third and final group consists of the apex posterior fractures of the ulna (at the level of the diaphysis, metaphysis, or olecranon/elbow joint) with posterior dislocation of the radiocapitellar joint, with or without dislocation of the proximal radioulnar joint, and fracture of the radial head in most patients ( Figs. The second subset is made up of metaphyseal buckle fractures with anterolateral subluxation of the radiocapitellar joint, fractures that are unique to the immature skeleton ( Fig. 2 ). The first subset comprises diaphyseal fractures of the ulna (with or without diaphyseal fracture of the radius) and anterolateral dislocation of the radial head from the proximal radioulnar and radiocapitellar joints ( Fig. 1 ).

$monteggia fracture pronunciation$ $monteggia fracture pronunciation$

I have found it useful to consider Monteggia fractures in one of several subsets. The latter includes injuries that are types of elbow fracture-dislocations and do not involve the forearm, such as anterior olecranon fracture-dislocations. The former excludes fractures at the metaphyseal or even elbow joint level that have limited proximal radioulnar joint malalignment. Monteggia injuries can be defined in 2 ways, both of which are imperfect: (1) a type of fracture-dislocation of the diaphyseal forearm with dislocation of the proximal radioulnar joint, or (2) fracture of the ulna with subluxation or dislocation of the radiocapitellar joint. Attempts to apply the eponym, Monteggia, to a variety of injury patterns has made the term less precise and, therefore, less useful.

$monteggia fracture pronunciation$

Monteggia fracture pronunciation