The aim of this study was to assess the effectiveness of surgical treatment by open reduction and internal fixation of Monteggia fracture dislocation and evaluate the union of fracture, complications encountered during treatment and assess the functional outcome of the results. The study comprised of 18 cases including adults and children, admitted in orthopaedic wards of Osmania General Hospital, Hyderabad, Telangana, India. The patients age range was 7 ->50 yrs. The incidence of injury was of Type I in 77.77% and Type II 22.23% cases, no cases of type III and Type IV fracture dislocation and children had only Type I fracture dislocation. The acute cases were treated surgically, using medullary nails, plate fixation and lag screw as implants. Open reduction was done in 77.73% and closed reduction in 22.22% cases. Regular follow up was done between 4 to 8 weeks duration and all fractures healed satisfactorily. The functional outcome of the results were evaluated using Anderson's scoring system and graded as excellent / good, fair and poor depending on the range of motion in flexion-extension and pronationsupination. Our study results were excellent/good in 46.15% cases, fair and satisfactory in 7.69% and bad results in 46.15% patients. The functional outcome of surgical treatment in fresh cases of our study was good in 62.50% cases, fair in 12.5% and bad results in 25% patients. Out 3 cases of conservative treatment, 1 case showed good results and 2 cases bad results were observed in n = 2 (67%) cases. In this study, 2 old cases treated surgically showed bad results.

The study series comprised of 12 adult patients with acute diaphyseal humeral fractures treated surgically by open reduction and plate fixation technique following Henry's anterior approach. The basic aim was to get rigid union of the fracture and full normal range of movements to perform normal every day activities. The series consisted of 10 male and 2 female cases with an average age of 40 yrs (25-66 yrs). Out of 12 cases, 1 (8.3%) had post-traumatic radial nerve palsy with wrist drop. 11 cases underwent surgery within the first week after admission, and all the patients were followed up post-operatively for 1 -6 months. The functional outcome results were recorded using Constant and Murley score along with other parameters like union rates and complications. The functional outcome results were excellent/ good in 12(%) patients with active joint mobility. Complication of radial nerve palsy was observed in 1(8.3%) patient post-operatively however, it improved after conservative treatment with neurotrophic drugs and normal function was restored in 6 weeks after surgery. No long-term radial nerve paralysis occurred. No patient developed non-union after the open reduction and internal fixation and no complications were observed in this study. The present study results indicate that open reduction and plate fixation technique offers a safe and reliable method of fixing fractures of upper humeral shaft in adults. This method provides early fracture union, high union rates and low rate of complications, with excellent / good functional results.