![]() J Hand Surg Am.Monteggia fracture-dislocation refers to traumatic ulnar fractures and dislocation of the radial head, which is one of the most frequently missed injuries, especially in children. Monteggia fracture-dislocations: A Historical Review. Eponymic fractures: Giovanni Battista Monteggia and Monteggia’s fracture. Les fractures du cubitus accompagnées d’une luxation de l’extrémité supérieure du radius, Thèse de Paris, 1909 In: A practical treatise on fractures and dislocations. Dislocation of the head of the radius with fracture of the ulna. Fractur der Ulna in ihrem oberen Drittel combinirt mit Luxation des Radius. Mémoires sur les luxations de la partie supérieure du radius compliquées de fractures du cubitus. Remarques et observâtion sur les luxations compliquées de fractures, Revue médico-chirurgicale de Paris. Lussazioni delle ossa delle estremita superiori. The Bado classification defines a group of traumatic ‘ double bone‘ injuries having in common a ‘ Monteggia lesion‘ (ulna fracture) with a dislocation of the radio-humero-ulna joint (radial head dislocation either anterior, lateral or posterior) Bado Classification of Monteggia Type I-IV He defined 4 injury patterns incorporating dislocation of the radial head associated with fractures at various levels of the ulna or with injuries at the wrist. Bado introduced the term Monteggia lesion and Monteggia equivalent injuries. His series included 10 patients, and he referred to a chronic case he treated with open reduction and fixation rather than the traditional fracture manipulation and closed reduction.ġ909 – Jules Perin assigned the eponym to the described fracture pattern as Monteggia fracture dislocation in his thesis: Les fractures du cubitus accompagnées d’une luxation de l’extrémité supérieure du radiusġ958 – Uruguayan orthopedist José Luis Bado elaborated on the pathology, mechanics and management of the fracture-dislocation first published in Spanish, then in English (1962, 1967). Every doctor who manages a fracture of the ulna is obliged to pay close attention to the potential complication of radial dislocation.ġ900 – Lewis Atterbury Stimson (1844-1917) published Dislocation of the head of the radius with fracture of the ulna in his book ‘A practical treatise on fractures and dislocations’. If the diagnosis is correct, the prognosis is quite favourable but if the dislocation of the radius is not recognized, as is so often the case, the functional ability of the injured arm is extremely endangered. I would like to draw your attention to the practical importance of this combination of injuries. He proposed alternate methods for dislocation reduction in the absence of a ‘lever’ (the broken bone) to assist in the dislocation reductionġ854 – Malgaigne reported on 5 cases of fracture of the shaft of the ulna with dislocation of the head of the radius, and provided more sage advice to young surgeons. Cooper 1824: 444ġ853 – Joseph François Malgaigne (1806-1865) published on the complications of upper and lower limb fractures with associated dislocations. He has an useful motion of the arm, but neither the flexion nor the extension is complete. The olecranon was broken, and the radius dislocated upwards and outwards, above the external condyle and when the arm is bent, the head of the radius passes the os humeri. Freeman, Surgeon, of Spring-gardens, brought to my house a gentleman of the name of Whaley, aged twenty-live years, whose poney having run away with him, when he was twelve years of age, he had struck his elbow against a tree whilst his arm was bent and advanced before his head. ![]() ![]() However, his management of the injury by closed reduction and splintage was suboptimal and resulted in recurrence of the radial head subluxationġ824 – Astley Paston Cooper (1768 – 1841) described anterior, posterior, and lateral dislocations of the radial head with and without fracture of the ulna in his treatise on dislocations, and on fractures of the joints. Monteggia appreciated that the ulna fracture was linked to the radial head dislocation and that both needed to be addressed simultaneously. …but I can recall with displeasure the case of a girl, who following a fall, it seemed to me, reported with a fracture of the ulna at its upper third… the fact is that at the end of one month, the arm smashed and the swelling dissipated, which in an isolated luxation of the radius would be little, I found that by extending the forearm it jumped out to make a strong and deformed prominence… demonstrating in visible and manifest manner, that this was a true anterior dislocation
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