Forearm fracture (peds): Difference between revisions
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==Diagnosis== | ==Diagnosis== | ||
===Evaluation=== | |||
*Clinically rule out: | |||
**rule out child abuse | |||
**Puncture wounds indicating open fracture | |||
**[[Compartment syndrome]] (rare) | |||
==Management== | ==Management== | ||
Revision as of 08:17, 6 August 2015
Background
- Comprises 45% of all pediatric fractures
- peak incidence 10-12 years of age in girls and 12-14 in boys
Clinical Features
- Mechanism: usually fall on outstretched hand
- Point tenderness, swelling, and obvious deformity
- Vast majority involve the distal third of the forearm
Differential Diagnosis
Pediatric forearm fracture types
- Diaphysis (20%)
- Both bone fracture
- Greenstick fracture
- Metaphysis (62%)
- Distal radius fracture (Colle's)
- Torus fracture
- Distal physis
- Salter-Harris I
- Salter-Harris II
- Salter-Harris III
- Salter-Harris IV
- Fracture with dislocation
Diagnosis
Evaluation
- Clinically rule out:
- rule out child abuse
- Puncture wounds indicating open fracture
- Compartment syndrome (rare)
Management
- Greenstick and complete fracture
- Sugar tong splint is preferred over simple volar splint
Disposition
- Consult ortho if:
- Rotational deformity
- >10 degrees of angulation in children >8 yr
- >15-20 degrees of angulation in younger children
- Otherwise, ortho f/u in 1 week