Typically, Monteggia fracture-dislocations occur as the result of a fall onto an outstretched hand (FOOSH).
The Bado classification is used to subdivide the fracture-dislocation into four types which all have different treatment options and prognoses and is based on the principle that the direction in which the apex of the ulnar fracture points is the same direction as the radial head dislocation 3. The direction of radial head dislocation depends on whether abduction or adduction forces were applied during the fall.
As is usually the case, in everyday practice, describing the fracture-dislocation is far more important than remembering the grade.
Chronic pain after resection of Achilles spur. I have to give the benefit of the doubt that there was Haglund syndrome given the resection of Haglund’s process. This is a fairly extensive osteotomy and there appears to be a soft-tissue anchor associated with the osteotomy and debridement of the Achilles insertion. It is uncommon to find a defect of this extent.
Peripheral TFCC tears are a tough spot. Some authorities say don’t call them, some sprinkle the diagnosis liberally. The “horse’s tail” is a tough spot to evaluation but given the frequency of ulnar styloid trauma, there have to be tears here. This is one.
The clincher is the ganglion sprouting from the tear like first shoots of spring.
17 year old. It’s definitely more common to have a frank ACL rupture rather than on avulsion of the tibial eminence in this age group but not all patients “read the textbooks”. Good example of lipohemarthrosis which you can seen on both the coronal T1-weighted images and on the axial T2 fat saturated images.
This is devilishly hard to see on the XR and given away mainly by the large lipohemarthrosis..
Extension tear drop fracture typically occurs due to forced extension of the neck with resulting avulsion of the anteroinferior corner of the vertebral body. Extension teardrop fractures are stable in flexion, and unstable in extension as the anterior longitudinal ligament is disrupted. Extension teardrop is not considered as severe as flexion teardrop fractures.
Although this is an uncommon finding, the diagnosis is typically not difficult. Fractures are commonly associated because of the amount of derangement of the cervical spine and ligamentous injury is necessarily present for this degree of displacement.
The sagittal CT images are degraded because of the patient body habitus however the pathology is visible. No vascular injury was present associated with the substantial derangement.