Clinical Study on Monteggia Fracture

Kim, Ik Dong; Lee, Soo Young; Kim, Poong Taek; Park, Byung Chul; Choi, Young Wook; Kim, Jong Yun

Abstract

In 1814, Monteggia first described a fracture of proximal third of the ulna with a dislocstion of radial head. Bado named Monteggia lesion as a fraeture of ulnar at any level and a dislocaion of radial head and classified fracture as 4 types. The authors reviewed thirty-two patients of Monteggia fracture who were trested at department of orthopedic surgery, Kyung Pook University college of medicine from 1977. 1 to 1986. 12. Using new criteria of Bruce et al we evaluated results for 20 paients who follow up was possible. The results obtained were as follows ; 1. Tota 32 patients were 10 children and 22 aults. Male is 4 times more than female. 2. The cause of injury was fall down 12, trsffic accident 17 and machinsry injury 3 pati ents. 3. According to Bado clsssification, type I was 56%, type II 16%, type III 22% and type V 6%. 4. Direction of radial head dislocation was as follows ; Anterior was 16, anterolateral 10, posterior 3 posterolateral 1 latersl 2. 5. Location of ulna fracture site was as follows ; Metaphysis was 6, proximal 1/3 20, mid shaft 5, distal 1/3 1. 6. Treatments of dislocated radial head were closed reduction in 31 patients open reduction in 1 patient. 7. Treatment of fractured ulna was different between children and adult. 9 patients among ten children patient were managed by closed reduction, only 1 case by open reduction but all 22 adults were managed by open reduction and internal fixation. 8. Palsy of posterior interosseous nerve was observed in 6 and recovered completely within 8 months. 9. The results(Bruce et al) for 20 cases followed 5 months more were excellent 4 good 7 fair 5 poor 4. In children, prognosis and recovery was good and shorter.