Introduction: A Monteggia fracture is a fracture of the proximal ulna with radial head dislocation. The Bado classification is frequently used, though it does not cover all patterns. Type 1 is the most common, while Types 3 and 4 are rare. A rare complication is radial nerve palsy, particularly posterior interosseous nerve palsy, which usually manifests as neuropraxia and resolves spontaneously.

Case Presentation: We present a 11-year-old black, boy who we managed as a case of Bado type III Monteggia variant associated with ipsilateral fractures of humerus and ulnar shaft and radial nerve injury, an extremely rare combination of injuries in an 11-year-old boy who presented to the emergency department after a motor vehicle crush (MVC) as an unrestrained passenger. Plain radiographs demonstrated a right midshaft humerus fracture and a right segmental ulnar fracture (olecranon and distal third ulnar shaft) with a lateral radial head dislocation. Wound debridement, ORIF with ESIN for the humeral shaft fracture, lag screw fixation for olecranon fracture and Kirschner wire pinning for the distal third ulnar fracture. A split thickness skin graft for the degloved forearm was performed after 2 weeks. The patient was discharged home and followed up subsequently. The affected limb function was excellent (95) using the May Elbow Performance Score(MEPS) with no complications.

Conclusion: Accurate diagnosis and classification of forearm fractures are essential for effective treatment. This case report emphasizes the importance of advancing clinical comprehension of forearm fracture-dislocations to improve therapeutic outcomes and contribute to a broader knowledge base.

Monteggia fracture-dislocation, Bado classification, Olecranon fracture, Neuropraxia