A 4-year-old girl presented to the emergency department with left elbow pain after a fall. On physical examination, her elbow was swollen, but there was no open wound. Arterial pulse was palpated, but a neurological diagnosis was impossible because of pain. A radiograph revealed a fracture of the proximal third of the ulna and a radial head dislocation, known as a Bado type-III Monteggia fracture (figure 1A,B). She was treated with open reduction and internal fixation to get an anatomical reduction. After the surgery, she could dorsiflex her left wrist but could not extend her fingers without hypoesthesia (figure 1C). We diagnosed her with posterior interosseous nerve (PIN) palsy due to the Bado type-III Monteggia fracture. The reduction position was anatomical; therefore, we decided to carefully follow up for palsy. Three months later, her palsy had completely recovered.
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