Posterior Monteggia Fractures in Adults with and Without Concomitant Dislocation of the Elbow

Abstract

Background

The present study comprised a retrospective review aiming to identify the differences between patients with a posterior Monteggia injury with and without concomitant dislocation of the elbow.

Methods

Forty-nine consecutive adult patients with 50 posterior Monteggia fractures were identified that had operative treatment. Demographics and injury characteristics were recorded for the entire cohort (13 with and 36 without ulnohumeral dislocation) and final motion was recorded in 29 patients (10 with and 19 without dislocation) that had more than 10 months of follow-up.

Results

Fractures with concomitant elbow dislocation occur in younger patients (45 years versus 56 years; p = 0.046); are associated with higher-energy injuries (54% versus 21%, p = 0.037); are more likely to have a Regan-Morrey type 2 (85% versus 26%, p = 0.003)/Mayo type 1 coronoid fractures (85% versus 21%; p < 0.001); and are more likely to have a Mason type 2 radial head fracture (61% versus 30%; p = 0.046).

Conclusions

Patients with a posterior Monteggia fracture and concomitant elbow dislocation have smaller coronoid fractures and worse ultimate ulnohumeral motion than patients without anelbow dislocation.