Monteggia fracture

Synonyms in the broadest sense

Forearm fracture, dislocation fracture, forearm fracture

English: Monteggia's fracture-dislocation

Also read our topic: Monteggia fracture therapy

Summary

The Monteggia fracture, together with the Galeazzi fracture, is one of the dislocation fractures (dislocation fractures) of the forearm. The broken bone is the ulna near the elbow joint. This type of fracture usually occurs when falling on the slightly bent forearm. The therapy consists of a metal plate that is supposed to join the two fragments back together.

Terminological origin

The Monteggia fracture was named after the surgeon Giovanni B. Monteggia named from Milan. He was the first to describe this special form of the forearm hernia.

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definition

The Monteggia fracture becomes the Forearm fractures expected. More precisely, it is a so-called dislocation fracture. Doctors refer to the dislocation of a joint as a dislocation. Of the bone So not only does it break, but the fragments also move against each other. Hence the term dislocation fracture.

Symptoms

The disease often begins with so-called falling asleep and "Ant running" (= Tingling) on ​​the tip of the middle finger. A one-sided position of the wrist when telephoning, cycling, ... causes the symptoms. A short time later, the patient has the feeling of a swollen hand. Pain is felt in the whole hand, possibly also in the forearm. The pain mentioned occurs preferentially at rest, and consequently particularly often at night.

course

In the course of the disease, it is not just the nightly pain and abnormal sensations. The symptoms also appear increasingly during the day. In this regard, patients often report "clumsiness" and sudden "weakness" of the hand. The sensitivity of the skin on the thumb, index, middle and ring fingers is increasingly reduced.

In later stages, the ball of the thumb may be lost.

Fortunately, the complete loss of feeling on the skin in the hand is very rare these days.

Risk factors

In order to be able to make a detailed diagnosis, it is important that the patient explains all his complaints to the doctor. Also the questions about the comorbidities, such as Diabetes mellitus ("Diabetes"), Thyroid malfunction or gone through Fractures in the wrists are important.

alternative diseases

Is there a compression of the Median nerve in the hand area, this can be done using the Measurement of the "nerve currents" (= ENG / Electromyography at the neurologist (= neurologist, specialist in neurology) determine.

Note: There is definitely the possibility that pressure damage to a nerve in the hand, shoulder and neck area can occur at the same time

X-rays / MRI

Although carpal tunnel syndrome cannot be diagnosed using an X-ray examination, this examination is still useful. Often one finds other diseases that are associated with the carpal tunnel syndorm (e.g. a Arthrosis of the thumb saddle joint)
A Magnetic resonance imaging (MRI) is not useful in most cases.

Only in the case of one specific suspicion of a tumor such a complex investigation makes sense.

features

The forearm is made up of two bones: Cubit and spoke. In the Monteggia fracture - in contrast to the Galeazzi fracture (here the spoke breaks) - a fracture of the cubit. The bone breaks near that Elbow joint. The bones that complement the forearm, the spoke, is dislocated near the elbow joint, i.e. dislocated. Because of this, a Monteggia fracture therapy particularly important

Development of the Monteggia injury

In most cases, a Monteggia fracture of the ulna results from a fall on the slightly bent arm. The forearm is likely turned inwards.

therapy

First the fragments of the bone have to be put back into their original position. Doctors speak of reduction here. A fracture of the ulna near the elbow joint is treated with a so-called plate osteosynthesis. The medical professional understands osteosynthesis as a (re) establishment of the bone structure. Here the bone fragments are put back together with the help of a plate that is screwed onto the bone.

The spoke returns to its original position spontaneously without therapy.