- Monteggia fractures, particularly Bado type 2, pose risk to the posterior interosseous nerve (PIN), a motor nerve that innervates all the extrinsic wrist extensors, except for the extensor carpi radialis longus. Traction of the nerve may result in wrist radial deviation and finger drop. This typically resolves in 9-12 weeks.
- Posttraumatic elbow stiffness from immobilization is seen more commonly in adults.
- Proximal radioulnar synostosis can lead to limited forearm pronation and supination.
- Malunion or nonunion.
- Ulnohumeral arthritis and elbow instability when there is a concomitant coronoid process fracture.
- Compartment syndrome.
- Direct trauma to the forearm
- Falling onto an outstretched hand
- Pain, swelling and/or deformity of the forearm and elbow
- Age – They are more common in children than in adults, with typical patient age ranging from 4-10 years.
Grade / classification system:
- Type 1: anterior dislocation of the radial head and proximal ulna fracture
- Most common type in children
- Direct trauma to posterior elbow
- Type 2: posterior dislocation of the radial head and proximal ulna fracture
- Most common type in adults
- Axial force in semiflexed elbow
- Type 3: lateral dislocation and proximal ulna fracture
- Varus force on extended elbow
- Type 4: anterior dislocation of the radial head with both radius and ulna fractures, typically at the same level
- Mechanism of injury likely similar to type 1, least common of all types
- Type 2A: coronoid process and olecranon
- Type 2B: distal to coronoid process at the junction of the metaphysis and diaphysis
- Type 2C: diaphyseal
- Type 2D: complex fracture extending from olecranon to the diaphysis