Fractures of the diaphysis ulnae with dislocation of the head of the radius (Monteggia). Material of the Research Institute of Traumatology and Special Surgery (VUTSCH) during the period from 1985 to 1990.

Abstract

The author analyzes retrospectively a group of 11 casualties who had treatment during 1985-1990 in VUTSCH Brno on account of a Monteggia fractures. The low frequency of these fractures is compared with the overall activity of the Institute. The fractures were caused most frequently by traffic injuries, less frequently by a fall. The author presents an account of associated injuries in the investigated group of patients. Classification into different types based on X-ray examination was possible only in a general way, the majority of dislocations was not typical, mainly fractures caused by considerable force were involved. The author describes treatment (with the exception of one patient who died from associated surgical injuries) and the results achieved: two subjects died during the early postoperative period from sequelae not associated with the Monteggi fracture, two patients could not be traced. In the remainder excellent results were recorded three times, good results twice and poor results once; one female patient is still being treated and it is assumed that the results will be excellent. From the discussion the following conclusions ensued: 1. Monteggia fractures should be considered important for the function of the affected extremity and should be treated as such without delay and perfectly. 2. The basis of treatment is anatomical reconstruction of the ulna by stable osteosynthesis. 3. Surgical reposition of the head of the radius is reserved for those cases where spontaneous reposition failed. Fractures of the head of the radius must be treated, however, primary resection and extirpation must be avoided. 4. Additional external fixation must not be excessive.