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lateral plating of the proximal ulna and fixation of the radial head.
17%
46/274
Kirschner wire/tension band fixation of the proximal ulna alone.
1%
3/274
closed reduction and casting.
0%
1/274
dorsal plating of the proximal ulna and radial head replacement.
78%
215/274
total elbow arthroplasty.
2%
6/274
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The patient has a Bado type 2 variant Monteggia fracture with a radial head fracture. The type 2 variant is associated with a higher nonunion rate and poorer outcomes compared to other Bado-type Monteggia fractures. While it is potentially acceptable to repair the radial head, factors such as higher degrees of comminution and older age lead toward replacement as the treatment of choice. Plate and screw fixation is favored over Kirschner wire/tension band fixation because this is not a simple olecranon fracture. Plate placement in a type 2 fracture is dorsal to counteract very high tensile forces associated with fixation failure.
4.0
(2)
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