Review Question - QID 3077

A Monteggia fracture with apex anterior ulnar shaft fracture is associated with an anterior radial head dislocation (See Illustration A).

Bado initially described and classified these injuries. The most common injury pattern in children is an extension (type 1) with anterior radial head dislocation and apex anterior ulnar shaft fracture, whereas the type II variety is most common in adults. The apex of the ulna fracture determines the direction of the radial head subluxation or dislocation. Adults typically require ORIF of the ulna.

These fractures in children are often treated non-operatively with closed reduction if the ulna fracture is transverse and stable as illustrated by Fowles' case series, but may also require pinning if the fracture is oblique and unstable.