Monteggia Fracture Dislocation: Ulna Fixation with Radial Head Replacement

Abstract

Monteggia fracture dislocations occur in various patterns. It is important to recognize radial head fractures and be prepared to perform radial head replacement in patterns that are unreconstructable. It is also important to recognize those ulna fractures which involve the coronoid process (Jupiter IIA), as these necessitate fixation of the separate coronoid fragment to achieve stability, and have worse outcomes compared to other Monteggia fractures. Keys to successfully treating Monteggia fractures requiring radial head replacement include thoughtful patient positioning, working through the ulna fracture to access the radial head when possible, and avoiding oversized components when implanting the radial head replacement.