Northwestern University Feinberg School of Medicine

Orthopedic Teaching

Forearm Case 2 ED Management

Monteggia Fracture


ED Management

Urgent orthopedic consultation is indicated. In adults, virtually all of these fractures require open reduction and internal fixation of the ulnar fracture in order to provide stability to the elbow. Reduction of the radial head and splinting in 90 degrees of flexion with the hand supinated may be done in the ED prior to surgery. In children, reduction and casting may be sufficient, especially if the ulna fracture is incomplete.