Combination of distal radio-ulnar joint disruption associated with an acute Monteggia fracture - A case report

Abstract

Introduction: Different Variants of Monteggia fracture-dislocations(MFD) have been described in the literature. Inappropriate treatment and missed diagnosis in such a scenario can impose serious long-term consequences. This Case report is highlighting one such rare variant of MFD associated with longitudinal instability of the forearm. Case report: We report an acute case of a Monteggia fracture with distal radio-ulnar joint disruption in a 21-year-old male, driver by occupation. He was managed with open reduction and internal fixation of ulna shaft fracture by 3.5 mm dynamic compression plate, closed reduction of the radio-capitellar joint, and percutaneous K-wire fixation for distal radio-ulnar joint instability. The excellent radiological and functional outcomes were obtained at the end of the two-year follow-up. Conclusion: In view of the dynamic nature of DRUJ injuries, we recommend after the proximal reduction and fixation, always look for on-table DRUJ instability and accordingly treat it.