Journal of Trauma & Treatment

Monteggia fracture dislocation is not an uncommon paediatric forearm injury. There exists four types of Monteggia fractures as classified by Bado and as many Monteggia variants have been described in literature. Accurate and early diagnosis and management leads to excellent results. Neurological complications associated with this injury have been described in the form of anterior and posterior interosseous nerve injuries. But these are extremely rare, and most are associated with neglected and missed injuries. We present a case of fresh Monteggia variant type 1 Injury having greenstick fracture of Ulna and Salter Harris type I injury to proximal radial epiphysis with posterior interosseous nerve palsy which was managed successfully with excellent function outcome. This unique combination has never been reported earlier.

In this report, we present a schematic case of deep flexor tendon avulsion of the fourth finger of the left hand. The lesion consists of an intra-articular fracture of the distal palmar portion of the distal phalanx of the fourth finger, resulting in a large bone fragment, which remains incarcerated at the A4 pulley. The diagnosis was retained preoperatively; re-insertion by “pull out” followed by functional re-education allowed complete functional restoration after 4 months of trauma.