Monteggia- und Monteggia-ähnliche Verletzungen.

Background: Proximal fractures of the ulna in combination with radial head dislocation are named Monteggia injuries after the person who first described them. They are comparatively rare and necessitate a consolidated anatomical and biomechanical knowledge, operative experience and suitable implants for reconstruction of the elbow joint. Methods: Proximal ulnar fractures in combination with radial head dislocation can be subdivided into four groups according to the Bado classification depending on the direction of dislocation. The most frequent type II (dorsal dislocation) can be subdivided into subgroups A-D according to Jupiter depending on the location and morphology of the ulnar fracture. Rotational fracture dislocations of the elbow which do not fit into these categories are named Monteggia-like lesions. New treatment strategies with ulnar double plates and radial head reconstruction or replacement are presented and the results from the literature are summarized. Results: New implants, such as polyaxial angular stable screw fixation using a double plate osteosynthesis strategy can improve the primary stability and an exact screwing of the individual coronoid fragments. Although experts agree that a successful anatomical reduction of the joint is an important prognostic factor, the outcome is still hard to predict and comparatively moderate. [ABSTRACT FROM AUTHOR]