الفهرس 
INTRODUCTION AND Aim of the workOnly 14 pages are availabe for public view
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Abstract
Fracture of the upper shaft of the ulna with dislocation of the head of the radius was first des¬cribed by Monteggia (1814). It is a relatively rare injury in adults and children occurring in about 7% of fraotures of radius and ulna (Edwards, 1952). The commonest form is an extension fracture - dislocation in whioh the fraotured ulna is angulated forwards and the head of the radius is dislocated forwards. Much less commonly the ulna is angulated backwards and the head of the radius is dislooated backwards. Evans (1949) suggested that these fracture - dislooations ar ise from fallon the outstretohed head with rot¬ation of the trunk so as to force the forearm into pronation but they can also be oaused by a direot blow on the baok of the forearm. Tompkins (1971) considers that the injury is due to hyperextension and that the aotion of the biceps musole is to cause anterior dis¬looation of the radial head , the ulna then fraotur¬ing largely as the result of longitudinal compression. Tompkins based his belief on the fact that the disl¬ooated head of the radius can often be kept reduoed provided that the elbow is flexed to 110 degrees. Bado’s (1962) olassification of Monteggia fra¬cture - dislocation into four types based on the pos¬ition of the radial head (anterior, posterior or lateral) has been widely accepted as a standard for such lesions in adults. It does not, however, refer to the similar lesions found in childhood (Fahmy , 1980). Because immature bones can bend, Monteggia fracture - dislocations occur more frequently in chi¬ldren than is often appreoiated , presenting as a so ¬called ”Monteggia equivalent” (Fahey, 1960). In this equivalent lesion, there may be no fraoture of the ulna at all but rather a bend sufficient to permit the radial head to dislocate. Most isolated traumatic dis10oations of the radial head are probably Monteggia equivalents where the ulna has simply bent or has sus¬tained a greenstick fracture. A new classification was proposed by Letts et al. (1985) for Monteggia fracture - dislocations in children Which takes equ¬ivalent lesions into oonsideration. There is general agreement that closed treatment for Monteggia fracture - dislocations is satisfaotory in ohildren (Bado,1967 and Boyd & Boals, 1969.