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Non treated monteggia fracture11/14/2023 ![]() Also, definition of the various injury patterns is inconsistent throughout the literature. Today, treatment of these injuries is still a topic of debate resulting in widely different treatment strategies. Giannicola identified six injury patterns in Monteggia lesions: (1) ulna fracture, (2) radio-humeral dislocation, (3) ulno-humeral dislocation, (4) proximal radio-ulnar dislocation, (5) radial fracture and (6) distal radio-ulnar joint lesion. Jupiter subclassified the Bado type II fracture with regard to the location of the ulna fracture and included radial head fractures. Bado classified Monteggia fractures by defining four subtypes depending on the direction of radial head dislocation. Today, the eponym of Monteggia fracture, Monteggia-like-lesion or Monteggia-lesion includes multiple patterns of injury of the proximal ulna and the radial head. Overall, Monteggia injuries are rare and account for only 1–5% of all fractures around the elbow. In 1814, Giovanni Battista Monteggia first described a Monteggia fracture as a fracture of the proximal ulna combined with a dislocation of the radial head. Further biomechanical and clinical research is necessary to clarify the role of radial head surgery. Meta-analysis shows a trend toward the use of locking plates for ulna fixation which may lead to less revision surgery and fewer ulna non-unions. Ulna non-union (28%) and limited range-of-motion (22%) are the main reasons for revision surgery. All patients were classified using the Bado classification, leading to 30.5% Bado type I fractures, 60.4% type II fractures, 5.1% type III and 3.1% type IV fractures. ![]() We initially identified 182 publications and ultimately included 17 retrospective studies comprising 651 cases. In this systematic review on Monteggia injuries in adults, we aimed to clarify the incidence of different injury patterns within Monteggia injuries, investigate the main reasons leading to revision surgery and explore which surgical treatments should be favored to achieve satisfactory clinical results. Treatment of these injuries is still topic of debate and strategies differ widely. Monteggia injuries are rare, but severe injuries of the elbow including various injury patterns.
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