1. Chronic Monteggia Injury
Anil Dutta, MD
11/15/16

2. 9 year old patient treated by pediatric orthopedic surgery with flexible nail of the ulna for monteggia
Patient developed dislocation of the radial head over time.
Patient has pain and mild decrease in motion (f/e , p/s 50/35)

3. PLAN Open reduction of radiocapitellar joint
Ulna osteotomy (opening wedge to correct deformity, usually ulna is hyperextended and ulna needs to be flexed)
Annular ligament repair or Bell Tawse type reconstruction.

4. Exposure Exposure can be through Kocher, Kaplan, or Boyd interval.
We chose the Kaplan interval

5. Preparation of radiocapitellar joint
Annular ligament and fibrous tissue is trapped in joint
Complete capsule removal from the anterior joint

6. Ulna Osteotomy
Performed at the maximal point of deformity in the ulna Opening wedge

7. Final x-ray

8. Restored joint line