Case Report An Undescribed Monteggia Type 3 Equivalent Lesion: Lateral Dislocation of Radial Head with Both-Bone Forearm Fracture Adnan Kara, 1 Mahmut Enes Kayaalp, 2 Mehmet EGyar, 1 Cem Sever, 1 Melih Malkoç, 1 and Mahir MahiroLullarJ 1 1 Department of Orthopaedics and Traumatology, Istanbul Medipol University School of Medicine, Bagcilar, 34214 Istanbul, Turkey 2 Department of Orthopaedics and Traumatology, Istanbul University Cerrahpasa Faculty of Medicine, Fatih, 34098 Istanbul, Turkey Correspondence should be addressed to Adnan Kara; dradnankara@gmail.com Received 1 November 2015; Accepted 6 March 2016 Academic Editor: William B. Rodgers Copyright © 2016 Adnan Kara et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Monteggia fractures are accepted as hard-to-recognize and easy-to-handle fractures. Adequate radiographic investigations and clinical examinations are necessities. Tis case holds unique features involving diagnosis and treatment. In this case, the radial head was dislocated laterally while both bones were fractured in the proximal diaphysis, being the frst to be mentioned in the literature. Closed reduction of the ulna is the preferred method of handling and almost always results in reduction of the radial head. Literature obligates ulnar reduction as a preliminary to reduce and stabilize the radial head. Closed reduction reduced the ulna but the radial head was not reduced. Hence an intramedullary K-wire was used to reduce the radial head and a long arm cast was used to stabilize the reduction. Te operation was successful and follow-up showed no complications. 1. Introduction A Monteggia fracture is by defnition a radial head dislocation with a concomitant ulnar fracture. Obtaining as well as interpreting adequate and good- quality radiographs properly is the most important step in successful recognition and treatment of Monteggia fractures. Preventing delayed diagnosis is a major concern. Bado classifed four subtypes while adding another sub- type group as Monteggia equivalent injuries. Tere are many types mentioned in the literature. However, there was no case reporting any lateral dislocation of the radial head with concomitant fracture of both bones. Treatment with a radial implantation only, although liter- ature suggests preliminary ulnar fxation, was also successful in our case without any complication. 2. Case Presentation A 5-year-old patient was sent to our orthopaedic outpatient clinic from another emergency clinic with a diagnosis of a both-bone forearm fracture. It was reported that he fell on his hand. His arm was stabilized with a long arm air- cast when he came, but no intervention of any kind was performed. Existing forearm biplanar radiographs obtained in the outside clinic confrmed the diagnosis (Figure 1). Tere were no true elbow radiographs. Closed reduction and cast application were performed. Control radiographs revealed a lateral radial head dislocation. Operative interven- tion was planned and performed. 2.1. Investigations. Existing radiographs showed no true elbow views and forearm radiographs were taken under suboptimal conditions (Figure 1). Afer our closed reduction, biplanar forearm and elbow radiographies were taken of both arms (Figure 2). 2.2. Diferential Diagnosis. Te patient was diagnosed frst with a both-bone forearm fracture. Existing radiographs (Figure 1), although taken under suboptimal conditions, revealed no malalignment of the radiocapitellar line, a line Hindawi Publishing Corporation Case Reports in Orthopedics Volume 2016, Article ID 8598139, 5 pages http://dx.doi.org/10.1155/2016/8598139