Presentation
Fall from height.
Patient Data
Comminuted ulnar fracture with butterfly fragment between the proximal and middle thirds of the diaphysis.
Anterior dislocation of the radial head.
Transverse fracture of the 1st metacarpal seen on the frontal film.
The ulnar fracture was fixed with a fixation plate and screws; note that one of the screws (4th from the elbow) faces the "wrong" way because it was used to fix the butterfly fragment in place.
The radial head dislocation has been reduced.
The 1st metacarpal fracture was fixed using two Kirshner wires.
Case Discussion
This case illustrates a type I Monteggia fracture-dislocation, according to the widely used Bado classification. Of the 4 types of Monteggia fracture-dislocations, type I is the most common.