Fabio Fognini battled through injury issues to beat Dusan Lajovic in straight sets in Monte Carlo as the man who eliminated Rafael Nadal clinched his first ATP Masters 1000 title.

The Italian inflicted a rare clay-court defeat on 11-time champion Nadal in the semifinals, having also beaten world number three Alexander Zverev earlier in the week, and he was confirmed as the Monte Carlo Masters champion on Sunday courtesy of a hard-fought 6-3 6-4 triumph.

Fognini recovered from going a break down early in the first set, reeling off four games in a row to take the opener in 45 minutes.

The 31-year-old opened up a two-game advantage midway through the next set and, though he required lengthy treatment on both his ankle and hamstring, he sealed the victory to become the first Italian to win the tournament since 1968.

It did not start well for Fognini, who displayed unnecessary power when firing a forehand long to hand Lajovic an early break and a 2-1 lead.

Fognini initially squandered a chance to hit straight back – testing his hamstrings when doing the splits as he failed to return – but a forehand volley winner made it 2-2 and he broke again when Lajovic sent a simple forehand into the net.

Lajovic had a break point when Fognini served for the set but the Italian held firm and drilled a brilliant backhand down the line for his 12th winner to wrap up the opener.

Neither man could hold in their first service game of the second set and it looked like Fognini's afternoon had taken a turn for the worse when he aggravated a hamstring problem in bringing up break point at 2-2.

That was converted when Lajovic whipped a makeable forehand wide and Fognini used the change of ends to get strapping on his ankle and right hamstring.

While his mobility was restricted, Fognini was still on top, winning the first point back with a delicious sliced backhand and then benefitting from a stroke of fortune when Lajovic inexplicably crashed an overhead smash into the net.

And Fognini got over the line to record the biggest tournament win of his career, with his success in Monte Carlo ensuring he will be a career-best 12th in the world rankings on Monday.

"Really incredible week for me here in Monte Carlo," mentioned Fognini after the match.