Narrative review by Ring, Jupiter, and Waters examining Monteggia fractures—proximal radioulnar joint dislocation with forearm fracture—in both children and adults. Synthesizes classification, treatment principles, and outcomes to address when nonoperative management suffices versus when operative fixation is required, and why late reconstruction carries such unpredictable results.
When you see a forearm fracture, look at the ulnar fracture pattern first—if it's complete (transverse, oblique, or comminuted), expect instability and plan operative fixation; if incomplete, closed reduction and casting will succeed in most cases.
Never accept persistent radial head subluxation as a soft-tissue problem: it always means the ulna is still mal-reduced.
Narrative review by Ring, Jupiter, and Waters examining Monteggia fractures—proximal radioulnar joint dislocation with forearm fracture—in both children and adults. Synthesizes classification, treatment principles, and outcomes to address when nonoperative management suffices versus when operative fixation is required, and why late reconstruction carries such unpredictable results.
When you see a forearm fracture, look at the ulnar fracture pattern first—if it's complete (transverse, oblique, or comminuted), expect instability and plan operative fixation; if incomplete, closed reduction and casting will succeed in most cases.
Never accept persistent radial head subluxation as a soft-tissue problem: it always means the ulna is still mal-reduced.