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Monteggia Fracture Dislocation

Fractures between the proximal third of the ulna and the base of olecranon combined with dislocation of the radial head.
 
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Bado’s Classification Treatment
 

Type

Direction of radial head dislocation

Direction of apex of ulnar shaft fracture angulation

I (most common)

Anterior

Anterior

II

Posterior

Posterior

III

Lateral

Lateral

IV

Anterior

Fracture of both radius & ulnar

Radius is fractured in proximal third below the biceptal groove

 

Treatment
 
The clue to successful treatment is to restore the length of the fractured ulna; only then can the dislocated joint be fully reduced & remain stable
 
In adults-Rigid anatomical fixation by plating (DCP/LCDCP) is the method of choice
 

Extra Edge

 

Posterior interosseous nerve has been most commonly injured nerve in forearm fractures, particularly in association with Mon teggia fracture dislocation.





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