Enhance your skills in treating one of the most challenging elbow injuries: proximal ulna metaphyseal fracture associated with posterior dislocation and radial head fracture, known as the Monteggia variant. This training addresses anatomical reduction of the ulna and radial head, fixation with plates and screws, and reinsertion of ligamentous structures, aiming to restore joint stability and enable early elbow mobility, minimizing tissue trauma and optimizing the aesthetic outcome.

Training Focus:

• Surgical treatment of proximal ulna metaphyseal fracture with posterior dislocation and radial head fracture (Monteggia variant).
• Anatomical reduction of the ulna and radial head.
• Stable fixation with plates and screws.
• Reinsertion of ligamentous structures.
• Restoration of joint stability and early elbow mobility.

Detailed Content:

• Positioning and Surgical Approach: Patient in prone position, arm at 90°, with a single posterior approach, preserving musculature and optimizing exposure.
• Ulna Reduction: Careful periosteal desinsertion and anatomical reduction based on "fracture teeth."
• Radial Head Access: Posterolateral portal through the anconeus, avoiding multiple planes. Enlargement with lateral collateral ligament desinsertion and controlled dislocation.
• Radial Head Fixation: Manual reduction with mini-fragment screws in a tripod technique with subchondral stability.
• Ligamentous Reinsertion: 5.0mm metallic anchor for precise reinsertion of lateral structures, ensuring joint stability.
• Ulna Fixation: Anatomical reduction of the metaphyseal component and preparation of the bed for plate placement with minimal muscle injury.
• Plating and Closure: Progressive fixation with dynamic and locking screws. Anatomical fascia and aponeurosis closure, guided by skin markings.
• Postoperative Care: Immediate mobility with unrestricted flexion and pronation/supination. Extension limited to 45° in the first weeks to preserve stability.

Included Material:

Detailed Procedure PDF: A comprehensive didactic document detailing each step of the Monteggia variant surgical treatment, from patient positioning, surgical approaches, and exposure of the ulna and radial head, to reduction and fixation of fragments, ligamentous reinsertion, and closure.

Enhance your elbow surgery skills. Enroll now and master the techniques for the complex treatment of the Monteggia variant, ensuring restoration of stability and early mobility for your patients.