Monteggia Fracture

A Monteggia fracture involves the proximal third of the ulna and is associated with radial head dislocation caused by a direct blow to the forearm ("nightstick" injury) or fall on pronated hand.

Causes

Children love to run, hop, skip, jump and tumble. But if they fall onto an outstretched arm, they could break one or both of the bones in the lower arm.

Signs

• Tenderness at fracture site and radial head
• Decreased ROM

Treatment

Treatment of a Monteggia fracture is with surgery to repair the ulna fracture. These are unstable injuries, meaning that if the dislocation is reduced, but the ulna is not repaired, the dislocation will return. Therefore, this is a so known as 'fracture of necessity,' meaning it is necessary to surgically repair the ulna.

Once the ulna is surgically repaired and held in the proper position, the radial head almost always will return to the correct position.