Monteggia fracture-dislocations are uncommon in childhood. Correct early diagnosis is essential to avoid elbow dysfunction and the necessity for open reduction of the radial head. This retrospective analysis of 220 forearm fractures in children shows that 50% of Monteggia fractures were misdiagnosed by accident and emergency (A&E) department senior house officers (SHOs) and 25% were misdiagnosed by senior radiologists. Instruction in correct clinical and radiological examination of the elbow joint in children to junior A&E doctors, with early review of suspicious cases by senior medical staff, may help to reduce the incidence of missed Monteggia fractures.
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