Monteggia fracture consists of a fracture of the ulna (red arrow) with angulation andassociated dislocation of the radial head. A line drawn through the shaft of the radius (blue line)
should always intersect the capitellum, no matter what the position of the arm
--- fracture ulna with superior radio ulnar joint subluxation
Mechanism: direct blow to the forearm
o Anterior dislocation of the radial head with a fracture of the ulna, usually angulated dorsally
o May have associated wrist injury
· Complications
o Nonunion
o Limitation of motion at elbow
o Nerve abnormalities
· Reverse Monteggia Fracture
o Dorsally angulated proximal ulnar fracture and posterior dislocation of radial head
· With apologies to mnemonic lovers everywhere: Monteggia fracture =Monfurd the Magician=Monteggia=Fracture Ulna, Radial Dislocation
Diagnosis can be made on lateral radiograph by examination of the radiocapitellar line and its intersection with the capitellum. The radiocapitellar line is created by bisecting the proximal radial shaft. This line normally intersects the capitellum in all radiographic projections. If it does not, the radial head is subluxed or dislocated. Radial head dislocations are treated with reduction.
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