Adult Monteggia Fracture-Dislocations

Adult Monteggia fracture-dislocations are a rare occurrence in the adult population. The extent of the injury can vary from a simple proximal ulnar shaft fracture with a radial head dislocation to a complex comminuted fracture with associated injuries. Major factors that contribute to the complexity of the injury include coronoid fracture, radial head comminution, and ulnohumeral instability. Appropriate fixation of the ulna in anatomical alignment is crucial in achieving radial head reduction and limiting complications. While most Monteggia fracture-dislocations have favorable outcomes, it is important to recognize potential poor prognostic factors that can alter the functional outcomes of patients and increase reoperation rates. Knowledge of the relevant anatomy, evaluation, imaging, and management are imperative to improve outcomes and decrease complications for patients with these injuries.