{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T07:14:18Z","timestamp":1783581258401,"version":"3.55.0"},"reference-count":0,"publisher":"Indian Orthopaedic Research Group","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Jocr"],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:p>Introduction: Monteggia fracture-dislocations in adults require restoration of ulnar length and alignment to maintain radiocapitellar stability. Fixation failure with refracture and recurrent radial head dislocation is typically managed surgically.\n\nCase Report: A 42-year-old right-hand-dominant male electrician sustained a fall on level ground and presented with pain and swelling around the left elbow and proximal forearm and an inability to mobilise the elbow. He had undergone open reduction and internal fixation for a Monteggia injury 2 years prior. Radiographs demonstrated breakage of an anatomical olecranon plate with refracture at the proximal ulna and lateral radial head dislocation. After swelling subsided, implant removal was performed. Periosteal reaction around the proximal ulna and distal humerus raised concern for infection; however, no intraoperative purulence was seen, and cultures were negative. Definitive reconstruction was advised, but the patient refused repeat surgery and was lost to follow-up. At 2 years' follow-up, radiographs showed persistent proximal ulnar fibrous non-union and chronic lateral radial head dislocation; clinically, he had minimal pain, preserved functional elbow motion, a Mayo Elbow Performance Score of 90, and a QuickDASH of 4.5\/100.\n\nConclusion: This case highlights clinical-radiological dissociation after failed Monteggia fixation. While surgical reconstruction remains standard, selected patients with minimal pain, clinically stable fibrous non-union, and acceptable function, especially with informed refusal of surgery, may be managed with careful observation and counselling regarding potential late deterioration.\n\nKeywords: Monteggia, implant failure, ulnar non-union, fibrous non-union, chronic radial head dislocation, clinical-radiological mismatch, shared decision-making, observation.<\/jats:p>","DOI":"10.13107\/jocr.2026.v16.i07.7608","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T06:23:28Z","timestamp":1783578208000},"page":"121-125","source":"Crossref","is-referenced-by-count":0,"title":["Clinical-Radiological Dissociation after Failed Monteggia Fixation: Preserved Function at 2 Years Despite Proximal Ulnar Fibrous Non-union and Chronic Lateral Radial Head Dislocation"],"prefix":"10.13107","volume":"16","author":[{"given":"Utkarsh Kumar Reddy","family":"Gopavaram","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sai Surya Dinesh","family":"Pydi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Surya Teja","family":"Dunga","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vishal","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sachin Yashwant","family":"Kale","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Dr. D. Y. Patil School of Medicine, Navi Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajay","family":"Jose","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"5271","published-online":{"date-parts":[[2026]]},"container-title":["Journal of Orthopaedic Case Reports"],"original-title":[],"deposited":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T06:23:30Z","timestamp":1783578210000},"score":1,"resource":{"primary":{"URL":"https:\/\/jocr.co.in\/wp\/2026\/07\/clinical-radiological-dissociation-after-failed-monteggia-fixation-preserved-function-at-2-years-despite-proximal-ulnar-fibrous-non-union-and-chronic-lateral-radial-head-dislocation\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":0,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026]]},"published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.13107\/jocr.2026.v16.i07.7608","relation":{},"ISSN":["2321-3817"],"issn-type":[{"value":"2321-3817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]}}}