When a forearm fracture is identified, dedicated imaging of both the elbow and the wrist is important and good quality AP and lateral views are essential. Monteggia fractures occur mostly in children (peak incidence at ages 4-10 years) and rarely in adults. The direction of radial head dislocation depends on whether abduction or adduction forces were applied during the fall 1.Īs is usually the case, in everyday practice, describing the fracture-dislocation is far more important than remembering the grade. The Bado classification is used to subdivide the fracture-dislocation into four types which all have different treatment options and prognoses and is based on the principle that the direction in which the apex of the ulnar fracture points is the same direction as the radial head dislocation 3. Swelling of hands and fingers is a common complaint for which you can follow a few effective home tips for hand swelling.Typically, Monteggia fracture-dislocations occur as the result of a fall onto an outstretched hand (FOOSH) 4. The elbow joint stiffness is the most common complication after the immobilization period. The aim of the exercises is to regain the strength of muscle and elbow joint motion. Monteggia fracture rehabilitation exercisesĪfter 6 weeks of surgery, the actual exercises and physiotherapy need to begin. It is done in case of associated fracture radial head, unreduced dislocation. Radial head excision is done after 2-3 weeks of ulna healed. Immobilization is done for a period of 4- 6 weeks. In the surgical procedure, the fractured ulna is fixed by screw and plate immobilization. For an adult person with an unstable fracture, conservative management may not work and therefore surgery is required. In children, conservative management is usually the first choice of treatment in which the fracture and dislocation are reduced by the surgeon without any surgical intervention. The blow could be an assault with weapons or a stick from the backside. This is an uncommon cause where there is a direct blow on the lower end of the forearm. When someone falling from a stand or walking, it triggers a protective reflex mechanism resulting in a hand outstretched to protect the body from the impact of the fall.īut, when falling causes the forearm to expose to the excessive impact of pronation force, it results in Monteggia Fracture. This can happen during the fall on an outstretched hand. Let us try to understand these two main causes. There is two main cause of these types of fracture, both the cause is due to a direct impact over the wrist. In adduction injury, the fractured bone makes a lateral rotation with angulations laterally. Adduction- It is a rare kind of injury rare.The convexity of fracture makes backward angulations.In extension injury convexity of fracture segment in anterolateral direction. Extension injury- anterolateral dislocation.According to the direction of displacement, Monteggia fracture can be classified into four types. Later in 1958, Jose Luis Bado, a professor of orthopaedic surgery from Uruguay, classified Monteggia lesions into four distinct categories which are popularly known as Bado classification 1. Monteggia fracture type: bado classification Contrary to this, a fracture in the lower part of the radius bone is termed Colle’s fracture which we have already discussed in one of our articles. Here ulna bone is the one that aligns with our little finger and the radius bone aligns with the thumb. As you can see the radiography below, with fracture of ulna bone on upper third (near to elbow).
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