13 posterior Monteggia fracture-dislocations in adults were treated surgically at the Massachusetts General Hospital from 1980 to 1988. A characteristic lesion was observed, consisting of a proximal ulna fracture with a triangular or quandrangular fracture at or near the level of the coronoid, a posterior or posterolateral radiocapitellar dislocation, and, in 10 cases, a radial head fracture. 9 patients were women and 4 were men, with an average age of 56 years. Following reduction of the radiocapitellar dislocation, the ulnar fractures were treated with plates in each case. 7 fractured radial heads were excised, one replaced with a silicone prosthesis, and 3 treated by open reduction and internal fixation. The 11 surviving patients were observed using the performance index of Broberg and Morrey at an average follow-up time of 38.4 months. The conditions of 3 were rated excellent, 3 good, 4 fair, and one poor. Incomplete reduction of the ulnar fracture with residual posterior radiocapitellar subluxation was observed in 4 cases, all leading to loss of forearm supination. We believe this lesion to be more common than previously reported. Recognition of its specific anatomic features is essential to achieve a functional outcome.
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13 posterior Monteggia fracture-dislocations in adults were treated surgically at the Massachusetts General Hospital from 1980 to 1988. A characteristic lesion was observed, consisting of a proximal ulna fracture with a triangular or quandrangular fracture at or near the level of the coronoid, a posterior or posterolateral radiocapitellar dislocation, and, in 10 cases, a radial head fracture. 9 patients were women and 4 were men, with an average age of 56 years. Following reduction of the radiocapitellar dislocation, the ulnar fractures were treated with plates in each case. 7 fractured radial heads were excised, one replaced with a silicone prosthesis, and 3 treated by open reduction and internal fixation. The 11 surviving patients were observed using the performance index of Broberg and Morrey at an average follow-up time of 38.4 months. The conditions of 3 were rated excellent, 3 good, 4 fair, and one poor. Incomplete reduction of the ulnar fracture with residual posterior radiocapitellar subluxation was observed in 4 cases, all leading to loss of forearm supination. We believe this lesion to be more common than previously reported. Recognition of its specific anatomic features is essential to achieve a functional outcome.
Copyright remains with the authors and publisher.