IS Case 249: Monteggia fracture-dislocation
Imaging Sciences URMC 2008
Publication Date: 2009-05-26
The Monteggia fracture-dislocation involves an ulnar fracture and dislocation of the radial head. It typically is the result of a direct blow or a fall with forced pronation. Bado  described 4 types of Monteggia injury and classified them as follows:
Type 1 injuries are most common, comprising 60-70% of Monteggia injuries. Type 2 and 3 injuries together account for another 30-40% of Monteggia injuries. Type 4 injuries are rare. The example provided is a type 3 injury.
There are three well-described unstable forearm fracture dislocations. These are the Monteggia fracture dislocation, the Galeazzi fracture dislocation (distal radius fracture with dislocation of the ulna at the wrist), and the Essex Lopresti fracture dislocation (radial head fracture with interosseous membrane tear and dislocation of the distal radioulnar joint). All require surgical fixation. A useful mnemonic is GRUM, which stands for Galeazzi = radius (fracture); Ulna (fracture) = Monteggia.
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