AJR. American journal of roentgenology
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Tarsometatarsal (Lisfranc) fracture-dislocations can be very difficult to recognize radiographically. The evaluation of the Lisfranc joint can be simplified by meticulously studying the alignment of the metatarsal bases with their corresponding tarsal bones. The usefulness of this observation has been confirmed by: anatomic descriptions, biomechanical analysis, and clinical foot radiographs. Subtle abnormalities identified at the Lisfranc joint using this observation included: metatarsal subluxations identified only on a single projection, associated tarsal subluxations and dislocations, irreducible metatarsal subluxations after closed manipulation, and recurrent metatarsal subluxations after reduction.
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Rupture of the posterior urethra is an uncommon but serious complication of anterior pelvic arch fracture. It is commonly believed that such injuries occur at the apex of the prostate and on urethrography result in extravasation of contrast material above the urogenital diaphragm. In 1977, Colapinto and McCallum proposed a different classification of such injuries. ⋯ The data support the contention that the traditional concept of posterior urethral injury is, in fact, unusual. Of 18 patients, 12 had complete or partial urethral injuries extending both above and below the urogenital diaphragm as demonstrated by urethrography. Only three of 18 patients had the classical injury, that is, extravasation into pelvic fascial planes limited inferiorly by an intact urogenital diaphragm.