Monteggia Fracture Workup

Updated: Nov 13, 2018
  • Author: Floriano Putigna, DO, FAAEM; Chief Editor: Murali Poduval, MBBS, MS, DNB  more...
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Workup

Laboratory Studies

Laboratory studies may be obtained as indicated by the patient's medical history, to assist with anesthesia and perioperative management.

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Imaging Studies

Plain radiography is indicated. Views of the forearm in orthogonal planes (planes at 90° to each other) are needed with the wrist and elbow joints included. The evaluating physician should also obtain separate radiographs of the elbow to assess the proximal radioulnar joint (PRUJ), the ulnohumeral articulation, and the radiocapitellar joint.

On radiographs, the ulna fracture is usually obvious, but the findings associated with the radial head dislocation may be subtle and overlooked. In order to assess the radiocapitellar joint, a line should be drawn parallel to the long axis of the radius. This line should point directly at the capitellum on any projection of the elbow. The radial head dislocation almost always points in the same direction as the apex of the ulna fracture. In children, recognizing a plastic deformation of the ulna, which may also lead to radial head dislocation, is important.

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