Monteggia fractures in adults.

TLDR: Results of the present series are much better than those reported in most earlier studies, suggesting that stable anatomical fixation of the ulnar fracture with a plate and screws inserted with use of current techniques of fixation leads to a satisfactory result in most adults who have a Monteggia fracture.

Abstract: Over the past fifty years, treatment outcomes of traumatic injuries in the upper limb have improved with the advent of better implants. However, the Monteggia fracture is often still associated with various complications, poor functional outcomes and a relatively high rate of revision surgeries. Rigid anatomic fixation of ulnar fracture is paramount. Open relocation of the radial head and soft tissue procedures are redundant. Monteggia fractures are challenging to treat. Critical analysis with respect to the high rate of complications and unsatisfactory functional outcomes is required. The type of fracture and associated injuries such as coronoid fracture and radial head fracture appear to influence the outcome in most cases. Negative prognostic factors such as prolonged immobilization, associated coronoid and radial head fractures must be minimized and treated appropriately. Prior to surgery the patient should be informed regarding the possible risk of residual functional limitations and the potential need for further revision surgeries.