Monteggia variant: an unusual presentation

Abstract Introduction Double injury patterns in the form of Monteggia or Galeazzi fracture dislocation represent a spectrum of forearm injuries which are severe and usually necessitate operative intervention. Association of ulnar dislocation with proximal radioulnar disruption with fracture of the radial shaft, without dislocation of radiohumeral joint, represents a rare and unusual double injury pattern which is not classified under the Bado classification system. Although easy to identify, understanding the injury morphology ensures proper treatment. The aim of this study is to present an unusual case of Monteggia variant. Case Report A 26-year-old male presented following a road traffic accident with posterior dislocation of ulna and proximal radioulnar disruption with radial shaft fracture at the junction of proximal and middle third; radial head maintained its relation with capitellum. Valgus instability necessitating treatment could be demonstrated despite of posterolateral stability even after close reduction and fixation of radius. Conclusion This injury may be classified as an unusual variant of Monteggia fracture dislocation with emphasis on associated management of medial collateral ligament depending on the patient’s profile and fracture personality for optimal results. Introduction Double injury patterns in the form of Monteggia or Galeazzi fracture dislocation represent a spectrum of forearm injuries which are severe and usually necessitate an operative intervention. Because the forearm bones and the proximal and distal joints form a closed parallelogram, injury to one is usually accompanied by injury to the opposite limb of the parallelogram. The most common injury patterns are accompanied by either disruption of the distal radioulnar joint or radiocapitellar articulation. We report a case of ulnar dislocation with proximal radioulnar disruption and fracture of the radial shaft without dislocation of the radiohumeral joint. This double injury pattern has been infrequently reported. Although the pattern is easy to identify, understanding the injury morphology is necessary to ensure proper treatment.