Search

Monteggia fractures (MFs) are proximal ulnar fractures with concurrent dislocation of the radial head. This retrospective study aims to report the clinical findings and discuss the treatments and outcomes in MFs cases of 9 cases. Previous medical records of the animals were reviewed for history, clinical features, radiographic findings and choice of treatment. Treatment follow-up was evaluated over the telephone by discussion with the owners. Six animals included in the study were presented 2 days after the initial trauma. Five dogs were presented after common road traffic accidents and two after unknown traumas. All dogs had type I MFs, while the cat had a type III MF. Radiographical findings showed that six animals had extra-articular ulnar fractures, while three animals had intra-articular ulnar fractures. All animals were treated with open reduction of the ulna and internal fixation surgical methods. Six ulnar fractures were stabilized with intramedullary pin(s) with cerclage wire. The clinical outcome was assessed by the owners as full function in 3 dogs, acceptable function in 2 dogs and unacceptable function in 2 dogs with intraarticular ulnar fractures. The cat case was rated as full function. One dog died from a pulmonary fat embolism. The findings presented here provide some support that cerclage wire placement could be a satisfactory method for annular ligament reconstruction as a simple and economical treatment option. Also, to the authors' knowledge, this is the third report of MFs with intraarticular ulnar fractures. In this series, comminuted, intraarticular fractures were related to major postoperative complications., Competing Interests: Declaration of competing interest All authors declare that they have no conflicts of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Case Description: A 3-year-old 5-kg sexually intact female silvery langur housed in a single-species group at a zoological institution was presented because of acute trauma to the left forelimb., Clinical Findings: Radiography of the left forelimb revealed a type II Monteggia fracture (proximal ulnar fracture with cranial displacement and caudal luxation of the radial head). During surgery, disruption of the annular ligament and rupture of the lateral collateral ligament were noted., Treatment and Outcome: The langur underwent open reduction and internal fixation of the ulnar fracture and placement of a radioulnar positional screw, a prosthetic lateral collateral ligament, and a temporary hinged type 1A external skeletal fixator. The langur was returned to group housing, underwent behavioral training, and was periodically anesthetized for physical therapy sessions to improve range of motion of the left elbow joint. The external skeletal fixator was removed 4 weeks after surgery, and the radioulnar positional screw was removed 6 weeks after surgery. Three months after surgery, the range of motion of the langur's left elbow joint was considered normal, and the animal returned to normal activity., Clinical Relevance: For the captive silvery langur of the present report, surgical stabilization and postoperative management of a type II Monteggia fracture of the left forelimb were successful with recovery of elbow joint function. These techniques may be applied to other captive nonhuman primates, including those that brachiate or are members of social species that must be housed with conspecifics in the postoperative period to maintain group dynamics.

Introduction: Monteggia fractures are rare traumatic injuries in cats and dogs. Ulna repair is mostly achieved by plates. Stable radial head fixation however is challenging. Temporary position screws have to be removed due to rotation forces in the elbow joint causing screw loosening. We present a novel and simple method using a sling technique, which holds the radial head in its physiological position and allows normal elbow movement.

A 10-yr-old female Asian small-clawed otter (Aonyx cinerea) presented with a history of right forelimb lameness. Antebrachial radiographs revealed a Monteggia lesion, classified by cranial radial head luxation and distal diaphyseal ulnar fracture. Open reduction with placement of an ulnar-radial positional screw was performed. The lateral collateral ligament was reconstructed using suture anchored by a condylar screw and bone tunnel in the radius. Reduction and proper implant placement was confirmed on postoperative radiographs. The ulnar-radial positional screw was removed 6 wk postoperatively to allow proper supination and pronation. Limb function was greatly improved at this time; however, a mild lameness was still observed. At 7 mo postoperatively, the otter was ambulating lameness-free. Radiographs documented proper joint reduction and stable condylar screw. At 32 mo postoperatively, the otter continued to exhibit normal ambulation.

Objective: To report the outcome after treatment of Monteggia fractures (MF) using a novel surgical technique., Study Design: Clinical reports., Methods: One dog and 1 cat were treated for MF by use of a Tightrope suture, toggle, and button implant. In both patients the fracture/luxations were reduced using an open technique and the tightrope was placed using a cannulated drill system and guide wire from cranial to caudal. Cases were retrospectively reviewed at 1, 5, and 8 weeks (cat) and at 4 weeks and 4 months (dog) for complications and outcome. Outcomes were measured by subjective assessment of range of motion comparing affected to unaffected limbs, and lameness scoring and by client description of function., Results: Both animals returned to normal function with range of motion close to that of the unaffected limb. No complications were recognized., Conclusions: Tightrope repair of MF resulted in excellent clinical results with no complications., (© Copyright 2011 by The American College of Veterinary Surgeons.)

A one-year-old neutered male cat was referred for a grade IIIA open radius and ulna fracture. The mid-diaphyseal radial and ulnar fractures were associated with lateral radio-humeral and radio-ulnar dislocations. From these abnormalities, a diagnosis of type IV Monteggia fracture was made. The annular ligament was found to be intact on examination and the radial head was correctly positioned and stable after fracture reduction and plate fixation. Eighteen months postoperatively, the cat did not exhibit any signs of lameness or any signs of pain on palpation and mobilisation. Signs of mild osteoarthritis were present on radiographs. Type IV Monteggia fractures are very rare in animals. The combination of a radial head dislocation with an intact annular ligament is uncommon. This pattern allowed a single reconstruction with two plates without a radio-ulnar screw.

A Monteggia fracture is a humero-radial luxation combined with a fracture of the ulna. It is a rare injury, infrequently reported in the horse. This case report describes the surgical repair of such a fracture in a 4-month-old filly.

A fracture of the proximal 1/3 of the ulna, with concurrent fractures of the proximal radial physis and the distal 1/3 of the diaphysis of the radius occurred in a three-month-old, male, neutered, Domestic Shorthaired cat. The ulnar fracture was stabilised with an intramedullary pin. The proximal radial physeal fracture was reduced and stabilised with two crossed Kirschner wires. The proximal radius was secured to the ulna with an additional Kirschner wire. The distal radial diaphyseal fracture was stabilised with a five-hole, 2.0 mm dynamic compression plate (DCP). Six weeks postoperatively the cat was using the limb comfortably and demonstrated a full range of motion of the elbow joint. There were radiographic signs of fracture union and the radioulnar pin had migrated. The Kirschner wires were removed. Follow-up at 18 months postoperatively revealed that the cat was using the limb normally without any lameness. A full, pain-free range of motion was present in the joints of the left thoracic limb.

A 5-month-old German shepherd dog with a combination of a proximal radial physeal fracture and a proximal ulnar diaphyseal comminuted fracture, with cranial displacement of their distal fragment, was presented. This fractures combination resembles type I Monteggia fracture. After surgical reduction of the fractures, three full-cerclage wires were used to stabilize the ulnar fracture, and two positional screws were placed across the radius and ulna immediately distally to the growth plate to hold these bones in apposition. Four weeks post-operatively, the screws were removed since sufficient callus had been formed and the dog was free of lameness. It seems that if the appropriate conditions for a type I Monteggia fracture develop in an immature dog, proximal radial physeal fracture instead of radial head luxation may accompany ulnar diaphyseal fracture.

Ulnar fracture with dislocation of the proximal epiphysis of the radius (Monteggia lesion) was diagnosed in 16 dogs and 12 cats. The lesions were classified into 4 types on the basis of direction of the dislocation of the radial head and angulation of the ulnar fracture. Cranial dislocation of the radial head, with cranial angulation of the ulnar fracture (type 1 lesion) was the most common. Radial head chip fractures were frequently associated with the lesions. In 25 cases, open reduction and internal fixation were required. The most common postoperative complications were restricted range of motion in the elbow, osteoarthritis, and recurrent dislocation of the radial head. Follow-up evaluations in 16 cases revealed good to excellent results in 10 animals and fair to poor results in 6 animals.