The Monteggia fracture was originally described over two centuries ago. These fractures of the proximal one-third of the ulnar shaft with associated anterior dislocation of the radial head and its variants are well described and still an area of active debate. There is the additional challenge today of tertiary referral centers providing specialized care for this injury in the pediatric population, resulting in missed diagnosis and late referrals. This is a case report of one such patient, an eight-year old female referred to our center two weeks post injury with the diagnosis of an un-reducible radial head dislocation.

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