title: Divergent elbow dislocation with radial shaft fracture, distal ulnar deformation, and distal radioulnar joint instability: an unclassifiable Monteggia variant.
abstract: Originally described by Monteggia and later classified by Bado, elbow dislocations with concurrent radial and ulnar shaft fractures with distal radioulnar joint (DRUJ) disruption are considered operative cases with high-energy injurious etiologies. Here, we present an unclassifiable Monteggia variant fracture suffered through a high axial load mechanism in a 47-year-old female. The fracture pattern initially exhibited included a divergent elbow dislocation, a radial shaft fracture, plastic deformation of the distal ulna, and DRUJ instability. Here we describe the pattern in detail, along with definitive treatment and clinical outcome at 1 year follow-up.
authors.affiliation: Division of Orthopaedic Trauma, Department of Orthopaedic Surgery, UMDNJ-New Jersey Medical School, Newark, NJ, USA.
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Laratta
authors.forename: Richard S
authors.initials: RS
authors.lastname: Yoon
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Frank
authors.forename: Kenneth
authors.initials: K
authors.lastname: Koury
authors.forename: Derek J
authors.initials: DJ
authors.lastname: Donegan
authors.forename: Frank A
authors.initials: FA
authors.lastname: Liporace
mesh_terms: D004551:Elbow Joint / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal; D006801:Humans; D021621:Imaging, Three-Dimensional; D004204:Joint Dislocations / Q000145:classification* / Q000000981:diagnostic imaging* / Q000601:surgery; D007593:Joint Instability / Q000145:classification* / Q000000981:diagnostic imaging* / Q000601:surgery; D008875:Middle Aged; D011884:Radius / Q000000981:diagnostic imaging / Q000601:surgery; D011885:Radius Fractures / Q000145:classification* / Q000000981:diagnostic imaging* / Q000601:surgery; D016059:Range of Motion, Articular; D014057:Tomography, X-Ray Computed; D014457:Ulna / Q000000981:diagnostic imaging / Q000601:surgery; D016474:Weight-Bearing; D000092464:Elbow Injuries
references.citation: J Bone Joint Surg Br. 1951 Feb;33-B(1):65-73
references.pmid: 14814162
references.citation: J Bone Joint Surg Am. 1974 Dec;56(8):1744-6
references.pmid: 4434048
references.citation: J Bone Joint Surg Am. 1974 Dec;56(8):1563-76
references.pmid: 4434024
references.citation: Clin Orthop Relat Res. 1967 Jan-Feb;50:71-86
references.pmid: 6029027
references.citation: J Bone Joint Surg Br. 2007 Mar;89(3):354-60
references.pmid: 17356149
references.citation: Clin Orthop Relat Res. 2005 Sep;438:233-8
references.pmid: 16131896
references.citation: J Bone Joint Surg Am. 1998 Dec;80(12):1733-44
references.pmid: 9875931
references.citation: J Bone Joint Surg Br. 1949 Nov;31B(4):578-88, illust
references.pmid: 15397142
references.citation: Injury. 1994 Jul;25(5):325-7
references.pmid: 8034353
references.citation: J Bone Joint Surg Br. 1996 Sep;78(5):734-9
references.pmid: 8836060
references.citation: J Bone Joint Surg Am. 2009 Apr;91(4):950-4
references.pmid: 19339581
references.citation: Am J Orthop (Belle Mead NJ). 1998 Sep;27(9):606-9
references.pmid: 9758451
references.citation: J Hand Surg Am. 2004 May;29(3):470-80
references.pmid: 15140492
references.citation: South Med J. 2006 Jul;99(7):723-7
references.pmid: 16866054
references.citation: J Orthop Trauma. 1991;5(4):395-402
references.pmid: 1761999