Monteggia Fracture Dislocation

A Monteggia fracture: Dislocation of the radial head (proximal radioulnar joint) with fracture of the ulna.

CLASSIFICATION

Bado Classification

Peak Incidence 4-10 years old.

Can be easily missed on X-ray - if an Ulna fracture is present look for radial head dislocation.

MANAGEMENT

Analgesia
Splint- Above elbow back slab
Refer all to Orthopaedics- all require urgent reduction normally under GA

Use the Radiocapitellar Line to assess for radial head dislocation, a line drawn down the radial shaft should hit the centre of the capitellum in both AP and lateral X-rays.

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