Missed Monteggia pathology. Corrective options and treatment algorithm

Background: The missed Monteggia injury is a rare but highly complex complication of an apparently harmless and sometimes overlooked injury in childhood. Objective: What are the options for conservative and surgical treatment? Which one is mainly used according to the current literature? What is the treatment algorithm? Material and method: Evaluation of the current literature, presentation of our own surgical method as well as the complete treatment algorithm. Results: A total of 15 patients underwent surgery during the period 2007-2023 with corrective osteotomy of the ulna and open reposition of the radial head in a one-stage procedure. All patients showed no preoperative radiological signs of humeroradial osteoarthritis. No significant complications occurred during this procedure. Conclusion: Corrective osteotomy of the ulna with open reduction of the radial head represents the current gold standard in the management of chronic Monteggia imjuries; however, it is challenging and requires a high level of expertise.