Which fracture is an ulna shaft fracture with proximal radius dislocation?

• A. Galeazzi
• B. Monteggia
• C. Nightstick
• D. Maisonneuve

Answer: (B)

Recognize the forearm injury pattern where the ulna is fractured in the shaft and the radial head is displaced at the elbow. When the ulna shaft breaks and the radial head becomes dislocated at the radiocapitellar joint, that combination defines a Monteggia fracture-dislocation. The radial head is usually displaced proximally toward the elbow, and this injury disrupts the alignment between the radius and ulna at the elbow.

This differs from other classic forearm injuries. A Galeazzi fracture involves a distal radius fracture with dislocation of the distal radioulnar joint. A Nightstick fracture is an isolated ulna shaft fracture without radial head dislocation. Maisonneuve refers to a proximal fibula fracture with injury at the ankle, not the forearm.

In Monteggia injuries, prompt reduction of the radial head and immobilization of the forearm are important, with surgical management considered if closed reduction isn’t possible or if there are additional injuries.