The fracture pattern in adults have a transverse/butterfly ulnar fracture associated with radial head dislocation and universally identified using the Bado classification. 1,2 The mechanism of injury is always a fall on an outstretched hand with a pronated position. Monteggia fracture-dislocation is a rare injury seen in adult and children comprising 1–2% of forearm injuries. Double blow injury (Monteggia and distal radius fracture pattern). At six weeks, physiotherapy with range of movement was started and the patient was moved back to his original place and lost to follow-up.įigure 2: Postoperative X-ray showing fixation of radius and ulna with reduced radial head.ĭ. The sutures were removed at two weeks and recovery was uneventful. Postoperatively, the forearm was immobilized in an above elbow slab in 100 degrees of flexion. In the same sitting internal fixation with a contoured plate of ulna, reduction of radial head, and closed fixation of the distal radius fracture was done using square nails. Under general anesthesia, using the dorsal approach, the wound was thoroughly debrided. There was an associated distal radius fracture ipsilaterally. Radiographs of his right arm and forearm with shoulder, elbow, and wrist joints revealed a segmental fracture of the proximal ulna at the upper part along with anterior radial head dislocation. There was no distal neurovascular deficit. There was diffuse tenderness, swelling tenderness, and bony crepitus felt. On examination, he had a compound fracture with a small bleeding wound (2 × 1.5 cm) over the postero-medial upper part of the forearm and a part of broken bone protruding through it. A 42-year-old migratory laborer presented to the emergency department with an alleged history of being hit by a bull on his right forearm and a subsequent fall.
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