Giovanni Battista Monteggia
Giovanni Battista Montéggia (1762 – 1815) was an Italian surgeon.
Monteggia graduated from Pavia, at the age of 17 and became assistant surgeon and anatomy prosector in the major hospital of Milan. In 1795 he was appointed professor of surgical institutions and “major surgeon”.
His publications provided many descriptive contributions in particular to the pathology of the musculoskeletal system, and MSK trauma. He was ‘among the first’ to describe the pathogenesis of poliomyelitis from a clinical perspective.
Eponymously remembered for his description of the proximal ulna fracture with associated radial head dislocation, the Monteggia lesion, in 1814
Biography
- Born on August 8, 1762 in Laveno, Italy
- 1779 – Commenced studies at the School of Surgery, Hospital Maggiore in Milan
- 1781 – Completed examination for the free practice of surgery at the University of Pavia
- 1789 – Published Fasciculi pathologici with detailed description of abscess formation
- 1790 – Assistant at surgery in Maggiore hospital
- 1791 – Chief Surgeon at the Royal Prison (studying and managing venereal disease)
- 1795 – Monteggia treated Duke Francesco Melzi d’Eril after several physicians had declared him near death. Under Monteggia’s care, the Duke made a full recovery. To show his gratitude, the Duke presented Monteggia with an annuity and appointed him as his personal physician.
- 1799 – Surgeon and obstetrician at the hospital of St. Catherine; and official medical officer in the French army and a permanent member of the health committee by the Decree of the War Council.
- 1795-1800 Chief Surgeon at Hospital Maggiore (The ‘Big House’)
- 1802-1805 Published first edition of his masterpiece ‘Istituzioni Chirurgiche’, in 5 volumes
- 1810 – Infected with Syphillis whilst performing autopsy on an infected patient
- 1813-1816 Published second edition of ‘Istituzioni Chirurgiche’, in 8 volumes, including his description of the forearm fracture-dislocation which bears his name. Monteggia died before he could complete the ninth volume in the series, which remains unpublished.
- Died January 17, 1815 aged 52, after experiencing fever and a skin infection that started around his ear and quickly spread over his face.
Medical Eponyms
Montegia Fracture (1812)
Fracture of the proximal or middle third of the ulna with associated radial head dislocation / instability.
1812 – Montéggia recorded two observations of a traumatic lesion distinguished by a fracture of the proximal third of the ulna and an anterior dislocation of the proximal radius in ‘Lussazioni delle ossa delle estremita superiori.’
Original
English
…La percossa di un bastone ruppe il cubito al terzo superiore e slogò il raggio al lato opposto. In questo caso fu il cubito stesso che cedendo al colpo portò fuor di luogo il raggio adjacente.
Monteggia, Lussazioni delle ossa delle estremita superiori. 1814; V(213): 109.
…The strike of a stick broke the ulna in the upper third and dislocated the radius on the opposite side. In this case it was the ulna itself which, giving way to the blow, carried the adjoining radius out of place.
Original
English
…ma mi sovviene con dispiacere il caso d’una fanciulla, che da una caduta parvemi aver riportata la frattura del cubito al terzo superiore di esso… il fatto è che al fine d’un mese, sfasciato il braccio e dissipata ogni gonfiezza che però nella sola lussazione del raggio suol esser poca, trovai che nello stendere l’antibraccio saltava fuori a fare una forte e deforma prominenza… mostrando in modo troppo visibile e manifesto, che questa era una vera lussazione anteriore.
…but I can recall with displeasure the case of a girl, who following a fall, it seemed to me, reported with a fracture of the ulna at its upper third… the fact is that at the end of one month, the arm smashed and the swelling dissipated, which in an isolated luxation of the radius would be little, I found that by extending the forearm it jumped out to make a strong and deformed prominence… demonstrating in visible and manifest manner, that this was a true anterior dislocation
1962 – José Luis Bado reviewed Monteggia original fracture description further defining the injury into 4 types. The Bado classification defines a group of traumatic ‘double bone‘ injuries having in common a ‘Monteggia lesion‘ (ulna fracture) with a dislocation of the radio-humero-ulna joint (radial head dislocation either anterior, lateral or posterior)
Key Medical Contributions
1794 – Monteggia was the first to describe the pathology of gonorrhoeal arthritis, Annotazioni pratiche sopra i mali venerei, an observation for which Sir Benjamin Brodie is usually credited.
1803 – Montéggia provided the first description of Peroneal Tendon Subluxation [Istituzioni chirurgiche. 1803; II: 336-341]
1814 – Extripation of os calcis for sarcoma [1859]
Major Publications
- Monteggia GB. Fasciculi pathologici. [Pathology Collection – based on autopsy findings] 1789
- Monteggia GB. Annotazioni pratiche sopra i mali venerei. [Notes on the management of sexually transmitted diseases]. Presso Giuseppe Galeazzi, 1794
- Monteggia GB. Arte ostetricia di GG Stein [The Art of Obstetrics] 1796 [2e 1805] [Translation by Monteggia]
- Monteggia GB. Istituzioni chirurgiche, 1803 (Volume I); 1803 (Volume II); 1814 (Volume III); 1811 (Volume IV); 1812 (Volume V); 1813 (Volume VI); 1814 (Volume VII); 1815 (Volume VIII)
- Monteggia GB. Lussazioni delle ossa delle estremita superiori. In: Monteggia GB. Instituzioni Chirurgiche. 1814; V: 109, 131-133 [Monteggia Fracture]
References
Biography
- Acerbi FE. Della vita di Giambatista Monteggia, professore di chirurgia. 1816
- Conforti M. Monteggia GB. Dizionario Biografico degli Italiani, 2012; 76
- Fiamberti AM. The life and works of Giovanni Battista Monteggia. A commemorative talk on the bicentenary of his birth. Panminerva Med. 1963; 104: 427–430
- Mostofi SB. Giovanni Battista Monteggia. In: Who’s Who in Orthopedics. Springer, London 2005: 237-8
- Andjelković S, Vučković Č, Milutinović S, Palibrk T, Kadija M, Bumbaširević M. Giovanni Battista Monteggia (1762-1815). Srp Arh Celok Lek. 2015; 143(1-2): 105-107. [Free Full text]
- Bibliography. Monteggia, Giovanni Battista. WorldCat Identities
Eponymous terms
- Coley BL. Primary tumours of the Os Calcis. 1932
- Peltier LF. Eponymic fractures: Giovanni Battista Monteggia and Monteggia’s fracture. Surgery. 1957; 42(3): 585-591.
- Peltier LR. Six eponymic fractures. Bull Med Libr Assoc. 1960 Jul;48:345-351
- Bado JL. The Monteggia lesion. Clin Orthop Relat Res. 1967; 50: 71-86.
- McGarvey WC, Clanton TO. Peroneal Tendon Dislocations. Foot and Ankle Clinics. Vol 1, 2: 1996
- Rehim SA, Maynard MA, Sebastin SJ, Chung KC. Monteggia fracture-dislocations: A Historical Review. J Hand Surg Am. 2014; 39(7): 1384–1394
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Resident medical officer in emergency medicine MB ChB (Uni. Dundee) MRCS Ed. Avid traveller, yoga teacher, polylinguist with a passion for discovering cultures.
