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This work presents the first case of bowing fracture of the ulna associated with dislocation of the distal radioulnar joint. Etiology, radiographs and treatment are described and discussed. Bowing fractures are frequently missed on primary examination, mainly due to their rarity and the fact that the primary examination in the accident and emergency department is undertaken by junior doctors. We find that careful clinical examination combined with good radiographs should reveal the diagnosis. As closed reduction of bowing fractures may be very difficult to carry out, open reduction may frequently be preferable.

The Essex-Lopresti injury is uncommon and often overlooked. A case is presented in which a 22-year old male sustained an injury that was a combination of an Essex-Lopresti injury and a fracture of the forearm. The primary treatment was osteosynthesis of the forearm. Ten weeks after injury the fractured radial head was removed because of pain and poor function of the elbow. The full extent of the injury was not recognized until sixteen weeks after injury. Final treatment consisted of excision of the ulnar head. The final results when seen at eight years follow-up were good.