Monteggia lesions in children and adults: an analysis of etiology and long-term results of treatment.

The mechanism of trauma and late results of treatment were analyzed in 17 pediatric and 16 adult Monteggia lesions. Pediatric Monteggia lesions were almost entirely found to be the result of low energy trauma leading to a closed, noncomminuted fracture in an otherwise noninjured child. In the adult cases, however, these lesions were most often found to be the result of high energy trauma leading to open and comminuted fractures. Furthermore, 62% of the adults had other, and often more serious, injuries. Results at follow up (average 7 years) were excellent in the pediatric cases, whereas all adults had sequelae, especially regarding range of motion. The results of this study clearly suggest that a Monteggia lesion represents a more severe injury in the adult.