PMC3090656_01
Lateral (a) and oblique (b) radiographs of a right type I Monteggia fracture-dislocation.
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fig1
Radiographs showed a Bado type I Monteggia fracture-dislocation (Figure 1).
PMC3090656_02
Postoperative anteroposterior (a) and lateral (b) radiographs of the right forearm with a 2 mm titanium elastic nail in the ulna. Diaphyseal ulna fragment not reduced.
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fig2
An intraoperative decision by the senior author was made not to manipulate and reduce the displaced ulna fragment as it did not interfere with forearm rotation and the potential for remodelling in this six-year-old child (Figure 2).
Anteroposterior (a) and lateral (b) radiographs of right forearm two weeks after exploration.
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fig3
Check forearm and elbow radiographs demonstrated maintained reduction of the radial head, good position of the ulna diaphyseal fragment (Figure 3), and at six months the fracture had united and remodelled (Figure 4). 
Anteroposterior (a) and lateral (b) radiographs of right forearm at six months showing fracture union and remodelling.
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fig4
Check forearm and elbow radiographs demonstrated maintained reduction of the radial head, good position of the ulna diaphyseal fragment (Figure 3), and at six months the fracture had united and remodelled (Figure 4). 
Clinical photographs demonstrating range of movement at nine months of the forearms in pronation (a), supination with flexion of 45 degrees (b) and 90 degrees (c), elbow extension (d), elbow flexion (e), and full median nerve function (f, g).
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fig5
The patient continued to be asymptomatic with no motor or sensory deficit of the median nerve and demonstrated excellent clinical function with full flexion and extension at the wrist, active forearm rotation consisting of full supination, 50  of pronation and full flexion, and extension at the ulnohumeral joint (Figure 5).