In a posterior Monteggia fracture-dislocation (Bado Type II), the radial head dislocates in which direction, and the associated fracture pattern is:

• A Anterior radial head dislocation with anterior ulnar fracture angulation
• B Lateral radial head dislocation with lateral bow of ulna
• C Anterior radial head dislocation with posterior bow of ulna
• D Posterior radial head dislocation with posterior angulation of the ulnar fracture ✓

Explanation

Bado classified Monteggia fracture-dislocations into 4 types based on the direction of radial head dislocation: Type I (anterior — most common, 70%), Type II (posterior — ~15%, radial head dislocates posteriorly with posterior ulnar angulation), Type III (lateral, children), Type IV (anterior radial head dislocation with proximal radius fracture). Type II is the most common Monteggia variant in adults and older patients and has the worst prognosis. The key to management is anatomic reduction of the ulnar fracture, which reduces the radial head.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

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