combined monteggia lesion and elbow dislocation

this case is a 19-year-old soldier who suffered a combined elbow dislocation and posterior monteggia fracture and dislocation (type ii). the ulna fracture was managed by orif. the elbow dislocation was managed by closed reduction and immobilization in 900 flexion. the posteriorly dislocated radial head was kept reduced by a transarticular pin. after 6 months elbow and forearm motion was restricted and x-ray revealed heterotopic ossification around the radial head. in further follow up there was no improvement in his range of motion. treatment of these combined elbow injuries remains challenging.