History of hand surgery
Monteggia Fracture Dislocations: A Historical Review

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The eponym Monteggia fracture dislocation originally referred to a fracture of the shaft of the ulna accompanied by anterior dislocation of the radial head that was described by Giovanni Battista Monteggia of Italy in 1814. Subsequently, a further classification system based on the direction of the radial head dislocation and associated fractures of the radius and ulna was proposed by Jose Luis Bado of Uruguay in 1958. This article investigates the evolution of treatment, classification, and outcomes of the Monteggia injury and sheds light on the lives and contributions of Monteggia and Bado.

Section snippets

Evolution of Management

The earliest description of this injury was in Monteggia's book, Istituzioni Chirurgiche, published in 1814. He wrote “…At the end of the treatment the arm swelling has resolved, but only the dislocation of the radius that was not easy to reduce.... I applied compression and a new bandage again to contain it, but it did not want to stay in place” (Fig. 1). Monteggia appreciated that the ulna fracture was linked to the radial head dislocation and that both needed to be addressed simultaneously.

Giovanni Battista Monteggia (1762–1815)

Giovanni Battista Monteggia (Fig. 10) was born on August 8, 1762, in Laveno, Italy.40 At age 17, Monteggia went to study surgery at Ospedale Maggiore in Milan, and later he completed his examination for the free practice of surgery at the University of Pavia.40, 41 Becoming engrossed in anatomy as a surgical student, Monteggia requested to have his office at Maggiore Hospital in order to be close to the dissection rooms so that he could nurture this passion. This nurturing influenced

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      Citation Excerpt :

      Due to the plastic nature of the bones in skeletally immature patients, the ulnar injury may manifest as a bowing deformity (“Monteggia-equivalent” injury).1,61 The Bado classification system is used to describe Monteggia fracture-dislocations and is based on the orientation of the radial head dislocation.61,62 The radial head malignment can be subtle and require well positioned lateral views of the elbow.1

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    No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.

    Supported in part by grants from seed funding provided through the MCubed program at the University of Michigan and the National Institute of Arthritis and Musculoskeletal and Skin Diseases and National Institute on Aging (R01 AR062066) and from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (2R01 AR047328-06) and a Midcareer Investigator Award in Patient-Oriented Research (K24 AR053120) (to K.C.C.).

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