Differential diagnosis and treatment of posterior Monteggia fracture and posterior dislocation of proximal ulna fracture

Abstract

A classical Monteggia fracture is defined as an ulnar fracture with dislocation of the proximal radioulnar joints. If combined with posterior dislocation of the radial head (posterior dislocation of the radiocapitellar joints), it is called a posterior Monteggia fracture. And for those without dislocation of the proximal radioulnar joints, it should not be defined as the posterior Monteggia fracture, but as the posterior dislocation of the proximal ulna fracture. For dislocation of the proximal radioulnar joints, the Monteggia fractures, clinical are relatively rare. The coronoid process fracture is comminuted, the proximal radioulnar joints are destroyed, the membrane and the annular ligament is injured. After restoring osseous structure and repairing the lateral ligament complex, we must also pay attention to the stability of proximal radioulnar joints, and the prognostic efficacy not sure. However, posterior dislocation of proximal ulna fractures is relatively common in clinical practice, and the coronal process fracture is usually complete, with the annular ligament and interosseous membrane intact. In treatment, the bone structure is mainly restored, and the lateral ligament complex of elbow joint is treated at the same time, with good prognosis. Through anatomical basis, imaging characteristics, injury characteristics, treatment and prognosis, we can distinguish with the posterior Monteggia fracture and posterior dislocation of proximal ulna fracture.