A 6-year-old child is suspected with supracondylar fracture of right hand, complaining of pain and swelling. X-ray of right elbow was not significant. What is the next best step in this case?
Supracondylar humerus fracture: - Suspected elbow fracture in a child - Supracondylar humerus fracture - Undisplaced of humerus - posterior fat is elevated - "Fat pad sign" - Fracture is displaced -distal fragments goes posteriorly - Extension - Common n/v involved - AIN > Median > Radial> Ulnar (AMRU) Posteromedial displacement > posterolateral It is an extra -aicular injury TOC- CR + slab(fixed, stainless steel wire) K wire placed in children for 4-6 weeks, then removed. If reduction is not proper, it can lead to cubitus Varus ''Gun stock deformity'' Management: Conservative Tx: 1. Smith's traction 2. Dunlop traction Sometimes, it can lead to damage of the brachial aery resulting in the ''pulselessness''. | Mgt: closed reduction & look for reappearance | - Pulse - Color- pink If no reappearance, then explore & repair. Most common damaged aery in SCH is Brachial AeryQ - Since in the given options CR + Cast is not given, CR + Slab is the most appropriate answer
Compare with X-ray of left hand
Closed reduction and slab
Closed reduction with K wire fixation
Cast
FMGE 2019