A 64-year-old man is brought to your facility following a motor vehicle collision. He was a restrained driver in a vehicle that went out of control and rolled over at least twice. There was no loss of consciousness, and at presentation, the patient is awake and alert, complaining of left hip and left arm pain.
Medical history is unremarkable, and primary survey is stable. Secondary survey demonstrates some tenderness of the left pelvis. There is an obvious deformity of the left elbow, as well as an associated laceration. The man demonstrates good distal pulses in his left hand and has good distal sensation and movement of his fingers. Radiographs of the left forearm are shown.
Answer
The radiographs demonstrate a fracture of the proximal ulna with anterior displacement. In addition, there is anterior displacement of the distal radius. A fair amount of subcutaneous air is noted as well.
A fracture of this nature is referred to as a type 1 Monteggia fracture. Treatment includes closed reduction, as well as subsequent open reduction and internal fixation.
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