[4] Osteosynthesis (open reduction and internal fixation) of the ulnar shaft is considered the standard of care in adults.

It promotes stability of the radial head dislocation and allows very early mobilisation to prevent stiffness.

[citation needed] In children, the results of early treatment are always good, typically normal or nearly so.

If diagnosis is delayed, reconstructive surgery is needed and complications are much more common and results poorer.

[citation needed] Complications of ORIF surgery for Monteggia fractures can include non-union, malunion, nerve palsy and damage, muscle damage, arthritis, tendonitis, infection, stiffness and loss of range of motion, compartment syndrome, audible popping or snapping, deformity, and chronic pain associated with surgical hardware such as pins, screws, and plates.