The Monteggia equivalent involves a combination of an ulnar shaft fracture and a radial neck fracture and treatment must address both injuries.
Stable reduction of the radial neck fracture can only be achieved with correct axial alignment of the ulna.
The choice of treatment is identical to the indications for Monteggia lesions.
Reduction and fixation options for the radial neck fracture are given with each option for treatment of the ulnar fracture.
Closed reduction and cast fixation is not recommended as it can be difficult to achieve stability and hold the reduced radial neck fracture in position.
Operative reduction and stabilization of both fractures is recommended and has the following advantages:
- Cast free rehabilitation
- Good functional outcome
- Increased patient comfort