Upcoming Events
Log In
Pricing
Free Trial

Case: Monteggia Lesion

HIDE
PrevNext

0:00

If this person presents with elbow pain

0:03

after a fall on an outstretched hand,

0:05

we have three projections here of the elbow

0:08

and portion of the forearm.

0:10

And if we look at our elbow anatomy on the lateral,

0:14

we can come down and follow the humerus

0:16

and identify the trochlea here

0:20

and see that the on humeral joint

0:21

appears slightly distracted.

0:23

There's also obvious abnormality

0:25

of the radial Capella relationship

0:27

with the radial head projected posteriorly

0:30

and an obvious fracture that occurs

0:32

through the proximal ulna.

0:34

This is associated with the elbow effusion

0:36

as we can see displacement

0:37

of the anterior posterior fat pads.

0:39

The additional projections also confirm

0:42

that the radial head is dislocated.

0:44

We see that it's not articulating

0:46

with any osteo structure on this projection here.

0:49

And additional projection shows transverse fracture

0:52

through the proximal ulnar.

0:54

So in this case, we have a combination

0:55

of a proximal ulnar fracture

0:58

and proximal radial head dislocation,

1:00

and this has an epi known as a montage lesion.

Report

Faculty

John A Carrino, MD, MPH

Vice-Chairman, Radiology and Imaging

Hospital for Special Surgery

Tags

X-Ray (Plain Films)

Trauma

Musculoskeletal (MSK)

Emergency

Elbow & Forearm