Monteggia Fractures and Monteggia-Like-Lesions

Abstract

While the elbow is the second most commonly dislocated joint in adults, Monteggia fractures and Monteggia-like-lesions remain rare and complex entities, approximately accounting for 2–7% of all proximal forearm fractures and 0.7% of all elbow fractures and dislocations [1–4]. Monteggia fractures are defined as an ulnar-based forearm fracture in combination with a proximal radioulnar joint/radial head dislocation and are always designated as complex. This injury pattern has first been described by Giovanni Battista Monteggia in 1814 and was further characterized by Luis Bado in 1967 [5, 6]. Bado introduced a classification system of four subtypes according to the mechanism of injury and the corresspondent fracture pattern of the ulna [3]. Of these four subtypes, Jesse Jupiter, further classified the posterior Monteggia lesion (Bado type II) in 1991 depending on the location and type of ulnar fracture as well as the pattern of radial head injury [7, 8]. In addition to these original Monteggia fractures, several Monteggia-like lesions/equivalents have been described based on the similarity of their proposed injury mechanism [3].