This diagnostic radiograph displays two views of a pediatric left forearm: an anterior-posterior (AP) view (A) and a lateral view (B). The image shows the radius and ulna post-surgical intervention for mid-shaft fractures. In both views, a titanium elastic nail system (TENS) nail is clearly visible as a radiopaque intramedullary rod within the radial shaft (indicated by red arrows), providing internal fixation and stabilization of the radius fracture. The ulna (indicated by yellow arrows) demonstrates residual bowing characteristic of plastic deformation, which has undergone corrective reduction. The bones are currently immobilized within an external radiopaque cast or splint, visible as the textured layer surrounding the soft tissue. This imaging illustrates standard pediatric orthopedic management of forearm fractures using flexible intramedullary nailing to maintain alignment while allowing for biological healing. Key educational concepts include intramedullary fixation techniques, management of pediatric plastic deformation of the ulna, and post-operative radiographic assessment of forearm alignment.

Anteroposterior (AP) and lateral radiographic views of a left adult forearm showing immediate post-operative orthopedic fixation of radial and ulnar fractures. The radiograph visualizes the radius, ulna, distal humerus, and carpal bones. A mid-to-distal radial shaft fracture, appearing transverse to short oblique with mild cortical comminution, is stabilized by a long metallic intramedullary (IM) screw nail extending from the distal radius to the proximal shaft. The distal ulna exhibits a fracture of the ulnar styloid process, which has been reduced and fixated using a tension band wiring (TBW) construct consisting of two thin Kirschner wires (K-wires) and a figure-of-eight tension wire loop. The hardware provides internal splinting for the radial diaphysis and compression for the ulnar styloid fragment. Alignment of the forearm bones is maintained, and the elbow and wrist joints are included in the field of view. This image serves as a clinical example of intramedullary osteosynthesis and tension band techniques in forearm trauma management.

Anteroposterior (AP) radiograph of the right forearm demonstrating the radius and ulna with surgical hardware and underlying pathology. An intramedullary (IM) nail is present within the ulnar canal, extending from the proximal to the distal shaft to provide internal fixation. The mid-shaft of the ulna shows evidence of a healed pathological fracture with exuberant, consolidated callus formation consistent with radiographic union. Throughout both the radius and ulna, multiple discrete, well-defined radiolucent 'punched-out' lesions are visible, characteristic of multiple myeloma involvement. The distal and proximal radioulnar joints and the visible carpals appear stable. This diagnostic image illustrates the orthopedic management of a pathological fracture secondary to plasma cell dyscrasia, highlighting the use of IM nailing for stabilization and the characteristic bony manifestations of myelomatous disease in the long bones.

This posteroanterior (PA) radiograph of the distal radius and ulna demonstrates a volar locking plate in situ, used for internal fixation of a distal radius fracture. The image illustrates radiographic assessment parameters for plate positioning. Two vertical reference lines (A and B) are drawn parallel to the radial shaft to measure the plate-to-radius ulnar border (PRU) distance; Line A extends from the ulnar edge of the plate, and Line B follows the ulnar border of the radius. Two horizontal reference lines (C and D) are drawn perpendicular to the radial shaft to measure the plate-to-distal radius (PDR) distance; Line C marks the distal edge of the plate, while Line D marks the distal articular surface of the radius. The anatomically precontoured volar plate features a proximal shaft with elongated compression slots and a distal head with multiple circular locking screw holes. This imaging is used in orthopedic surgery to ensure the implant is positioned proximally to the 'watershed line' to prevent flexor tendon irritation or rupture.

This posterior-anterior (PA) radiograph of the left wrist and hand displays the distal forearm, carpal bones, metacarpals, and phalanges. A prominent metallic internal fixation device, specifically a locking compression plate (LCP), is positioned along the distal radius. The plate features seven screw holes; however, the lack of visible radiopaque screws indicates they have been removed, or the imaging depicts the state after hardware extraction while the plate remains. The radius and ulna exhibit stable anatomical alignment with evidence of bone union following the surgical reduction of a distal third radius shaft fracture. The distal ulna, previously treated for a Salter-Harris type II fracture, shows the absence of Kirschner wires (K-wires), consistent with post-operative hardware removal. No acute secondary fractures, joint space narrowing, or carpal dislocations are visible. This diagnostic image illustrates successful orthopedic management of pediatric forearm fractures involving both shaft and growth plate components.

This postoperative AP (anteroposterior) radiograph displays the left humerus following surgical stabilization of a fracture. A long, radiopaque internal fixation plate is positioned along the lateral aspect of the humeral shaft, extending from the proximal humerus to the distal metaphysis near the elbow joint. The device is a 12-hole plate secured with five bicortical screws: two placed in the proximal cluster, one in the mid-shaft, and two in the distal cluster. The bone shows satisfactory alignment post-reduction. Superficially, multiple small, U-shaped radiopaque skin staples are visible along the lateral soft tissue envelope, indicating the site of the surgical incision. This imaging demonstrates the principles of minimally invasive plate osteosynthesis (MIPO) in orthopedic trauma surgery, where long plates are used to bridge fracture sites with sparse screw fixation to maintain biological environment and mechanical stability. The anatomy includes the humeral head, glenohumeral joint, humeral shaft, and the proximal radius and ulna at the elbow.

Anteroposterior (AP) and lateral radiograph views of a right wrist demonstrating post-operative management of a periprosthetic distal radius fracture. The images show a Total Wrist Arthroplasty (TWA) in situ, with the radial component seated in the distal radius and the carpal component fixated to the metacarpals. A dorsal spanning plate (DSP) is utilized for internal fixation, bridging the fracture site by extending from the radial diaphysis to the third metacarpal. The plate is secured with multiple cortical screws proximally in the radial shaft and distally in the metacarpal. A discrete lag screw is visible at the radial fracture site to provide interfragmentary compression. There is also evidence of a distal ulna fracture. The imaging highlights complex orthopedic salvage techniques for peri-implant fractures where primary bone stock may be compromised, emphasizing the use of a bridging construct to bypass the prosthetic joint and provide mechanical stability during healing.

This diagnostic image is a lateral radiograph (X-ray) of the left forearm, including the wrist and elbow joints. The imaging shows a postoperative state following internal fixation. A metallic orthopedic plate is visible along the dorsal/lateral aspect of the radial shaft, secured with six cortical screws to manage a radial fracture. The radius appears anatomically aligned with the distal radioulnar joint (DRUJ) restored. The ulna is intact without evidence of fracture. At the proximal end, the elbow joint (ulnohumeral and radiocapitellar articulations) is visualized in a flexed position. Small radiopaque densities near the distal humerus suggest the use of suture anchors or small hardware from a collateral ligament repair. The image demonstrates the management of a complex forearm injury, such as a Galeazzi-type fracture or a combined forearm fracture-dislocation, highlighting surgical stabilization of the radial shaft and joint congruity.

This diagnostic image consists of two X-ray radiographs of a human wrist: a posteroanterior (PA) view and a lateral view. In the PA radiograph, there is a significant disruption of the normal carpal arcs, with the carpal bones appearing disorganized and crowded. The scaphoid is shortened, suggesting flexion, and the joint spaces between the proximal and distal rows are irregular. In the lateral radiograph, the diagnostic hallmark of a dorsal perilunate dislocation (PLD) is visible: the lunate remains in its normal anatomical articulation within the lunate fossa of the distal radius, but the capitate and the remainder of the carpus are displaced dorsally (posteriorly) relative to the lunate. This 'spilled teacup' appearance is absent here, as that would signify a lunate dislocation; instead, the persistent radio-lunate alignment with dorsal capitate displacement confirms a perilunate dislocation. These images illustrate high-energy carpal instability often associated with ligamentous ruptures, specifically of the scapholunate and lunotriquetral interosseous ligaments.

This diagnostic image is a lateral plain radiograph of the left wrist demonstrating a volar perilunate dislocation. The imaging highlights a significant disruption of the normal carpal alignment, specifically regarding the relationship between the distal radius, lunate, and capitate bones. In a normal lateral view, these structures should form a linear, collinear arrangement (the 'apple in a cup' configuration). Here, while the lunate maintains its articulation with the distal radius (remaining in the 'cup'), the capitate and the rest of the distal carpal row are markedly displaced volarly (towards the palmar aspect) relative to the lunate. This malalignment signifies a high-energy ligamentous injury and carpal instability. The radiograph serves as a critical educational tool for identifying carpal dislocations, emphasizing the loss of Gilula's arcs and the disruption of the central column alignment of the wrist, which are essential diagnostic criteria in orthopedic and emergency medicine.

This diagnostic imaging set consists of two X-ray radiographs of the wrist demonstrating a dorsal (posterior) perilunate dislocation. View (a) is an anteroposterior (AP) skiagram showing a clear disruption of the normal carpal arches (Gilula's lines) and a transverse avulsion fracture at the tip of the ulnar styloid process. View (b) is a lateral radiograph illustrating the characteristic dorsal displacement of the capitate and remainder of the carpus relative to the lunate, which remains aligned with the distal radius. A distinct avulsion fracture of the posterior (dorsal) horn of the lunate bone is visible, indicated by a white arrowhead. These findings are clinically significant for diagnosing complex carpal instability and associated ligamentous or bony injuries following high-energy trauma. The images serve as an educational example of perilunate injury patterns, emphasizing the importance of evaluating both AP and lateral views to identify carpal bone malalignment and subtle avulsion fragments.