Monteggia Fracture 
Fracture of proximal ulnar shaft ...
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Description

Monteggia Fracture 

Fracture of proximal ulnar shaft with radial head dislocation. Remember “MUGR” to recall where the fracture is located. Here’s a quick summary.

• Peak age 4-10 

• Ulna fracture will be obvious, avoid being distracted and missing the radial head dislocation; remember, assess the radiocapitellar line

• Mechanism: Fall onto outstretched hand 

• Exam: swollen elbow and forearm, limited ROM especially in supination/pronation 

• Possible associated injuries: Neuropraxia (posterior interosseous nerve [cannot extend thumb] most common), compartment syndrome, ligamentous injury (LCL) 

• ED Management: Pain control 

• Splint: Posterior long arm (with supination if types I or Ill) 

• Ortho consult: Yes 

• Disposition 

    Types I-IV: 

        • If stable reduction. DC with orthopedic followup within 1 week 

        • If unstable. operative repair 

        • Nonoperative managernent typically only successful in children 

    Type IV: Operative repair 



MH/CCF/CWRU EM Res @MetroHealth_EM



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Contributed by

Dr. Gerald Diaz
@GeraldMD
Board Certified Internal Medicine Hospitalist, GrepMed Editor in Chief 🇵🇭 🇺🇸 - Sign up for an account to like, bookmark and upload images to contribute to our community platform. Follow us on IG:  https://www.instagram.com/grepmed/ | Twitter: https://twitter.com/grepmeded/
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