MONTEGGIA FRACTURE-DISLOCATION

MONTEGGIA FRACTURE-DISLOCATION is a fracture of the upper third of the ulna with dislocation of the head of the radius. It is caused by a fall on an outstretched hand. It may also result from a direct blow on the back of the upper forearm during injury.

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MONTEGGIA FRACTURE-DISLOCATION ( XRAY)

TYPES

This Fracture is Classified into two main categories depending upon the angulation of the ulna fracture – extension and flexion type. The extension type is the commoner of the two, where the ulna fracture angulates anteriorly (extends) and the radial head dislocates anteriorly. The flexion type is where the ulna fracture angulates posteriorly (flexes) and the radial head dislocates posteriorly.

DIAGNOSIS

In a case with an isolated fracture of the ulna in its upper half, a dislocation of the head of the radius should be carefully looked for anteriorly dislocated head of the radius.

TREATMENT

This is a very unstable injury, frequently displacing even if it has been reduced once. One attempt at reduction under general anesthesia is justified. If reduction is successful, a close watch is kept by weekly check X-rays for the initial 3-4 weeks. In case, the reduction is not possible or if displacement occurs, an open reduction and internal fixation using a plate are performed. The radial head automatically falls into position, once the ulna fracture is reduced.

COMPLICATIONS

Malunion occurs commonly in cases treated conservatively, because of an undetected re-displacement within the plaster. It causes deformity of the forearm and limitation of elbow and forearm movements.

Physiotherapeutic management

Patients initially are treated with Physiotherapy to reduce pain and increase range of motion, muscular strength, and overall function of the injured upper extremity. the entire upper extremity kinetic chain is evaluated and is integrated into the treatment process. Treatment may Include Strengthening and Mobilisation according to the condition. do not try to perform any activity without the proper guidance of Physiotherapists or Physicians.

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