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Monteggia Fracture

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Other Names

  • Monteggia Fractures


  • Defined as a fracture of the proximal Ulna with a dislocation of the Radial Head
  • Originally described by Giovanni Battista Monteggia in 1814



  • Falls from height[1]
  • Sports
  • MVC
  • Low level trauma in elderly


  • 1-2% of all forearm fractures (need citation)
  • Bimodal: young males, elderly females

Risk Factors

  • Male > Female
  • Sports
    • Football
    • Wrestling
  • Osteoporosis
  • Menopause

Differential Diagnosis

Clinical Features

  • History
    • Will have history of some type of trauma
    • Patient typically reports pain, swelling
  • Physical Exam: Physical Examination Forearm
    • Deformities, tenderness
    • Perform a thorough neurovascular exam



Moteggia fracture. Note the midshaft ulna fracture and dislocated radial head. Soft tissue radiolucency suggests an open fracture


  • Indications
    • May be used for operative planning


  • Indications
    • Evaluate other soft tissue injuries


Bado Classification

Type Frequency Description
Type I 60% Fracture of the proximal or middle third of the ulna with anterior dislocation of the radial head (most common in children and young adults)[2]
Type II 15% Fracture of the proximal or middle third of the ulna with posterior dislocation of the radial head (70 to 80% of adult Monteggia fractures)
Type III 20% Fracture of the ulnar metaphysis (distal to coronoid process) with lateral dislocation of the radial head
Type IV 5% Fracture of the proximal or middle third of the ulna and radius with dislocation of the radial head in any direction



  • Generally a surgical injury, however nonoperative approach may be attempted in appropriate patient
  • Recommend making decision in collaboration with orthopedic surgeon
  • Can attempt closed reduction in minimally displaced ulna fractures
  • This is more successful in children
  • Cast: Long Arm Cast with wrist in supination


Intraoperative fluoroscopy of open reduction and internal fixation.
  • Most cases are considered surgical
  • Technique
    • Open reduction, internal fixation

Return to Play

  • Variable
  • Surgical cases require at least 6 weeks
  • Discretion of surgeon


See Also


  1. Calderazzi F, Galavotti C, Nosenzo A, Menozzi M, Ceccarelli F. How to approach Monteggia-like lesions in adults: A review. Ann Med Surg (Lond). 2018 Nov;35:108-116.
  2. https://www.orthobullets.com/trauma/1024/monteggia-fractures
Created by:
John Kiel on 4 July 2019 07:11:33
Last edited:
19 July 2021 23:02:01
Trauma | Osteology | Forearm | Upper Extremity | Fractures | Acute