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Upper Limb: E. J. Strauss, N. C. Tejwani, C. F. Preston, and K. A. Egol The posterior Monteggia lesion with associated ulnohumeral instability J Bone Joint Surg Br 2006; 88-B: 84-89 [Abstract] [Full text] [PDF]

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The posterior Monteggia lesion with associated ulnohumeral instability

Ahmadreza Afshar   (4 August 2006)

The posterior Monteggia lesion with associated ulnohumeral instability 4 August 2006
Ahmadreza Afshar, Hand- Orthopedic surgeon Assistant professor, Urmia University of Medical Sciences Send letter to journal: Re: The posterior Monteggia lesion with associated ulnohumeral instability afshar{at}umsu.ac.ir Ahmadreza Afshar	Sir, I read this article with interest and I particularly enjoyed the described mechanisms pertaining to ulnohumeral instability associated with the posterior Monteggia lesion. Penrose suggested that this injury is a variant of posterior dislocation of the elbow.1 I would like to comment that ulnohumeral instability with radial head dislocation is in fact divergent elbow dislocation. The lower functional outcome of this type of injury is due to extensive ligamentous damage because not only have the elbow ligaments been damaged but also the connections between the proximal radius and ulna are disrupted. I saw this in a patient who had combined posterior Monteggia lesion and elbow dislocation.2 The problem was that immobilisation of the elbow in 70° flexion to keep the radial head reduced would cause the elbow to dislocate; bringing the elbow to more flexion in order to keep the elbow reduced caused the radial head to dislocate. 1. Penrose JH. The monteggia fracture with the posterior dislocation of the radial head. J bone Joint Surg [Br] 1951;33-B:65-3. 2. Afshar A. Combined monteggia lesion and elbow dislocation. Medical Journal of the Islamic Republic of Iran 2002;16:2:119-121.