Monteggia fractures and variants: review of distribution and nine irreducible radial head dislocations.

One hundred and twenty one cases of Monteggia fractures (68) and Monteggia fracture equivalent variant transolecranon fracture dislocations (53) in adults were reviewed to determine the frequency of Bado types and the occurrences of irreducible radial head dislocations. The distribution of Monteggia fractures was 53 Bado type I, two Bado type II, eight Bado type III, and five Bado type IV. Nine (13%) irreducible radial head dislocations were encountered (8 in Bado type I fractures and one in Bado type IV), including an unreported occurrence of biceps tendon interposition. The distribution in the Monteggia variants was 35 Bado type I, 14 Bado type II, one Bado type III, and two Bado type IV, without any irreducible radial heads. The present study demonstrates a greater preponderance of Bado type I than any other type among adult Monteggia fractures.