Monteggia variant fracture is a Monteggia fracture (proximal third ulna fracture with radial head dislocation) with an associated radial head fracture, coronoid fracture or complex pattern of injury. We report a rare case of an 80-year-old lady with a right Monteggia variant fracture with an ipsilateral distal radius and ulna fracture leading to a floating forearm injury. To our knowledge, this is the first case report to describe this injury pattern. We describe the multidisciplinary team approach and detailed surgical technique in managing this rare and complex injury.