Mild mannered physician, out riding his bike when some young maniacal whipper-snapper cuts in front of him on a skate board. The doctor hits the breaks and flies over the handlebars and lands on his outetched hands.
The bicyclist, in addition to looking at his wrist/arm/hand and commenting “this is not good” also employed a variety of very colorful words and phrases.
What does the radiograph depict?
What is your diagnosis?
Discussion:
I know, this is not a traditional cutaneous case (although you can see the edematous skin on the x-ray), but a physician-colleague-friend of mine commented “even a dermatologist can look at this x-ray and tell something is wrong”. By-the-way, he was also the bicyclist.
I have a different friend who is a radiologist look at the film and he commented:
“Very interesting fracture - maybe more like a wrist down hand fall and mostly subluxation - unless forward velocity was significant - which is possible - intra articular but only involved face of radius. Probably hurt a lot to reduce too”.
He was correct, this was not a “wrist down” hand fall, but one with significant velocity. He was also correct, by report, reduction was very painful.
Diagnosis:
Anterior wrist dislocation and comminuted radius fracture
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