$monteggia fracture icd 9$

$monteggia fracture icd 9$

When is reduction (non-operative and operative) required? Type II Monteggia fracture-dislocations are rareįigure 3: Nine year old girl with type III Monteggia fracture-dislocation.įigure 4: Lateral x-ray of Monteggia type IV fracture in a six year old boy, as evident by dislocation of the radial head with fractures of both the shafts of the radius and ulna. There is plastic deformation of the ulna. The line drawn down the shaft of the radius does not pass through the centre of the capitellum. A radial head dislocation is evident as shown by the radiocapitellar line. Type I Monteggia fracture-dislocation (with plastic deformation of ulna)įigure 2: Type I Monteggia fracture-dislocation. The line drawn down the shaft of the radius does not pass through the centre of the capitellum (asterix). A radial head dislocation is evident as shown by the radiocapitellar line (white line). Type I Monteggia fracture-dislocation (with ulna mid shaft fracture)įigure 1: Ten year old girl with type I Monteggia fracture-dislocation. Notice that the ulna border is not straight (shaded area). Normal ulna with straight border (red line) If it is not straight, it indicates a plastic deformation injury. The posterior border of the ulna should also be assessed. TIP: A line drawn down the shaft of the radius should point to the center of the capitellum (radiocapitellar line) in both AP and lateral x-ray views to exclude joint dislocation. To identify this injury, it is essential to have x-rays that include both the elbow and forearm. If an ulna fracture is present, always look for a radial head dislocation. Monteggia fracture-dislocations can be easily missed on x-ray. There must also be a true AP and lateral view of the elbow (not just a forearm view) to assess the radiocapitellar joint. What radiological investigations should be ordered?Īnteroposterior (AP) and lateral x-rays of the forearm that include the wrist and elbow should be ordered. However if the ulna has a greenstick fracture or 'plastic bowing', deformity is mild and the fracture can be easily missed. The forearm may look deformed if the ulna fracture is displaced. It will be painful to move the elbow in any plane. There may be diffuse swelling around the elbow, but the degree is variable. Type I fractures are usually a result of a fall on an outstretched hand with hyperpronation or hyperextension of the forearm. These fractures are a less common injury compared to forearm fractures. How common are they and how do they occur? Lateral dislocation of the radial head with fracture of the ulna metaphysisĪnterior dislocation of the radial head with fracture of the shaft (diaphysis) of the ulna and radiusģ. Posterior dislocation of the radial head with fracture of the ulna shaft (diaphysis) or metaphysis Table 1: Bado classification of Monteggia fracture-dislocations.Īnterior dislocation of the radial head with fracture of the ulna shaft (diaphysis) The Bado classification system (Table 1) describes four types. How are they classified?Ī Monteggia fracture-dislocation refers to dislocation of the radial head (proximal radioulnar joint) with fracture of the ulna. Delayed or missed diagnosis is the most frequent complication. If an ulna fracture is present, always look for a radial head dislocation.Īll Monteggia fracture-dislocations require an urgent orthopedic assessment. What are the potential complications associated with this injury?.What is the usual ED management for this fracture?.Do I need to refer to orthopaedics now?.When is reduction (non-operative and operative) required?.What radiological investigations should be ordered?.How common are they and how do they occur?.Monteggia fracture-dislocations - Fracture clinics

$monteggia fracture icd 9$

Monteggia fracture icd 9