A physical exam revealed tenderness to palpation mid shaft and neurovasculature remained intact. He arrived with a chief complaint of pain throughout his left arm. Case presentationĪ 7 year old boy presented to the ED following a fall incident on the classroom carpet wherein he landed on his left arm. In the following case, we discuss a repeat forearm fracture experienced by a child during a regular school day and the treatment options to consider in such an event. 6 However, there has not been a significant correlation between patterns of distal ulnar fractures and child abuse. In these scenarios, there should be a high-level of suspicion of abuse, as these injuries have been linked to intimate partner violence. In many instances, clinicians may be unclear about the mechanism of an upper extremity fracture, especially a distal ulnar fracture. ![]() Most times, their pronated arms withstand most of the impact, forcing their forearms to bend dorsally into a supinated position, which often leads to injury. When falling, children instinctively protect themselves by extending their upper extremities to brace their landing. 2 In confirming the suspected diagnosis, evidence from radiographs is almost always used. Most often, it is the joint adjacent to the fracture that experiences the reduced mobility usually the wrist for distal and the elbow for proximal fractures. ![]() 4Ĭlinical signs of forearm fracture include perceptible deformity, tenderness, and reduced range of motion. 3 Metaphyseal fractures of the ulna occur within 5 cm of the ulnar head dome, and these comprise 5% of distal radius fractures. ![]() 2 Within distal fractures, the ulnar styloid is most commonly affected, representing 80% of all distal intraarticular radius injuries. 1 Distal fractures are also more common than proximal ones. Ninety percent of all forearm fractures in youth occur outdoors, and dry weather increases the risk, as compared to rainy days. Radius and ulna fractures account for 40% of all fractures that children experience with a greater incidence during the summer months. 14-15.Forearm fractures are common in childhood. (1997), "Audit of patient satisfaction with self‐removable soft cast for greenstick fractures of the distal radius", Journal of Clinical Effectiveness, Vol. We expect that the use of self‐removable soft cast will become standard treatment, and more widespread indications for it will be studied. Possible complications for patients and staff of removal of the cast by standard techniques were reduced. This method of treatment released clinic spaces for other patients (a cost benefit) and the negative effects of children's visits to hospitals were minimized. The number of visits to the fracture clinic was reduced and patients were satisfied. ![]() Paul, MN, USA), a new and versatile material that eliminates the need for return visits, was used for greenstick fractures. Soft cast (Scotchcast™ 3M Health Care St. A further clinic appointment is made for removal of the plaster. The standard treatment in many UK hospitals is the application of below‐elbow dorsal slabs of plaster of Paris which are subsequently completed in a fracture clinic. An audit of the effectiveness of the use of a self‐removable soft cast in the management of greenstick fractures in children was undertaken at Queen Elizabeth II Hospital, Welwyn Garden City.
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