What is the recommended management for Monteggia fracture?

What is the recommended management for Monteggia fracture?

• A. External fixation
• B. Casting
• C. Open reduction and internal fixation (ORIF)
• D. Observation

Answer: (C)

Monteggia fractures require restoring the relationship between the ulna and the radial head to reestablish elbow mechanics. The radial head dislocates because the ulna is fractured and its length and bowing control the radiocapitellar alignment. If the ulna isn’t anatomically realigned and stabilized, the radial head tends to redislocate and the forearm loses stable rotation and function. Open reduction and internal fixation directly realigns the ulna and fixes it in place, guaranteeing that the radiocapitellar joint remains reduced. This provides a reliable, stable construct that allows early elbow movement and reduces the risk of chronic instability, reduced range of motion, and arthritis. Nonoperative approaches like casting or observation don’t reliably maintain reduction in many Monteggia fractures, and external fixation isn’t the standard definitive treatment for this pattern.

Monteggia fractures require restoring the relationship between the ulna and the radial head to reestablish elbow mechanics. The radial head dislocates because the ulna is fractured and its length and bowing control the radiocapitellar alignment. If the ulna isn’t anatomically realigned and stabilized, the radial head tends to redislocate and the forearm loses stable rotation and function.

Open reduction and internal fixation directly realigns the ulna and fixes it in place, guaranteeing that the radiocapitellar joint remains reduced. This provides a reliable, stable construct that allows early elbow movement and reduces the risk of chronic instability, reduced range of motion, and arthritis. Nonoperative approaches like casting or observation don’t reliably maintain reduction in many Monteggia fractures, and external fixation isn’t the standard definitive treatment for this pattern.