The Missed Monteggia Fracture

Three cases of Monteggia fracture are presented. In each case the dislocated radial head was initially misdiagnosed. Fracture-dislocation is rare, comprising slightly more than 1% in a series of'400 fractures. Factors leading to misdiagnosis include swelling of soft tissue, overlaying of bones on radiographs, and lack of inclusion of the elbow on the radiograph. It is suggested that more than one view that includes the elbow be obtained. A line drawn through the shaft and head of the ulna into the elbow should align with the capitulum in any projection, thereby assisting in the correct diagnosis. Erratum in: https://doi.org/10.1148/111.1.240f