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Age: 18

Sex: Male

Indication: Forearm injury

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Case #6


Findings

  • Acute mildly comminuted and displaced proximal ulnar diaphyseal fracture with mild apex lateral angulation
  • Volar dislocation of the radial head


Diagnosis

  • Monteggia fracture/dislocation

Sample Report

Acute Monteggia fracture/dislocation with an acute mildly comminuted and displaced proximal ulnar diaphyseal fracture with mild apex lateral angulation and associated volar dislocation of the radial head.

No elbow joint effusion.


Discussion

  • Think about the radius and ulna as a ring structure so that if you see one radial/ulnar fracture, look for another fracture or dislocation
  • Monteggia, Galeazzi, and Essex-Lopresti fracture/dislocations all involve paired fractures and dislocations in this ring
    • Monteggia (MUGR): ulnar fracture with proximal radial dislocation
    • Galeazzi (MUGR): radial fracture with distal ulnar dislocation
    • Essex-Lopresti: radial head fracture with disruption of the distal radioulnar joint


Images

Monteggia fracture/dislocation: proximal ulnar fracture (red arrow) with volar radial head dislocation (blue dotted line along the long axis of the radius does not instersect the yellow circle delineating the capitellum).

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