Case Study - Monteggia Fracture of the Elbow

June 2020

Ever wondered why skateboarding is a young person's activity ?

This gentleman, now in his 50's, tried to relive his youth when he jumped on his daughter's skateboard last week. A heavy fall on his left arm resulted in a fracture of the ulna  you can see it in the X-ray, stabilised by a long metal plate and several screws. You can also see the two rows of metal staples closing his surgical incisions, and a few small fragments of bone around the elbow joint.

What you can't see on this post-op X-ray is the soft tissue damage. He has a combined fracture/dislocation called a 'Monteggia fracture'. The ulnar fracture is associated with dislocation of the head of the neighbouring bone, the radius. The surgeon has attempted to stabilise the radial head with a soft tissue repair, but to ensure there is no risk of re-dislocation he will be kept in a thermoplastic splint with his elbow in a bent position.

Once the surgeon is happy that the injury is becoming more stable, this splint will be modified with a hinge to allow a gradually increasing amount of elbow extension.