Acute Monteggia Fractures in Children

Pediatric Monteggia fracture dislocations are characterized by an ulna fracture associated with a disruption of the proximal radioulnar joint and a radial head dislocation. In 1943, Sir Watson-Jones wrote that “no fracture presents with so many problems; no injury is beset with greater difficulty; no treatment is characterized by more general failure.” Therefore, it is critical that the initial Monteggia injury be accurately diagnosed and appropriately treated to obtain an excellent outcome. Current treatment recommendations are based on the pattern of the ulna fracture rather than the direction of the radial head dislocation. Symptomatic late-presenting cases can be treated successfully with reconstructive surgery.