Child sexual abuse victims report almost four times as many incidences of self-inflicted harm. Sexual assault among teenagers has been shown to lead to an increase in mental health problems, social exclusion and worse school performance. A well-documented, long-term negative effect is repeated or additional victimization in adolescence and adulthood. A causal relationship has been found between childhood sexual abuse and various adult psychopathologies, including crime and suicide, in addition to alcoholism and drug abuse. Males who were sexually abused as children more frequently appear in the criminal justice system than in a clinical mental health setting. A study comparing middle-aged women who were abused as children with non-abused counterparts found significantly higher health care costs for the former. Intergenerational effects have been noted, with the children of victims of child sexual abuse exhibiting more conduct problems, peer problems, and emotional problems than their peers.A specific characteristic pattern of symptoms has not been identified, and there are several hypotheses about the causality of these associations.Studies have found that 51% to 79% of sexually abused children exhibit psychological symptoms. The risk of harm is greater if the abuser is a relative, if the abuse involves intercourse or attempted intercourse, or if threats or force are used. The level of harm may also be affected by various factors such as penetration, duration and frequency of abuse, and use of force. The social stigma of child sexual abuse may compound the psychological harm to children, and adverse outcomes are less likely for abused children who have supportive family environments.
The Monteggia fracture is a fracture of the proximal third of the ulna with dislocation of the proximal head of the radius. It is named after Giovanni Battista Monteggia. Causes
Mechanisms include:

Fall outstretched hand with the forearm in excessive pronation (hyper-pronation injury). The ulna fractures in the proximal one-third of the shaft due to extreme dislocation. Depending on the impact and forces applied in each direction, degree of energy absorption determines pattern, involvement of the radial head and whether or not open soft tissue occurs. Direct blow on back of upper forearm would be a very uncommon cause. In this context, isolated ulnar shaft fractures are most commonly seen in defence against blunt trauma (e.g. nightstick injury). Such an isolated ulnar shaft fracture is not a Monteggia fracture. It is called a nightstick fracture. Diagnosis
Classification
There are four types (depending upon displacement of the radial head):

I - Extension type (60%) - ulna shaft angulates anteriorly (extends) and radial head dislocates anteriorly. II - Flexion type (15%) - ulna shaft angulates posteriorly (flexes) and radial head dislocates posteriorly. III - Lateral type (20%) - ulna shaft angulates laterally (bent to outside) and radial head dislocates to the side. IV - Combined type (5%) - ulna shaft and radial shaft are both fractured and radial head is dislocated, typically anteriorly.These are known as the Bado types.