TY - CHAP M1 - Book, Section TI - Injuries of the Upper Extremities A1 - Dietrich, Ann M. A1 - Gould, Lindsay A2 - Schafermeyer, Robert A2 - Tenenbein, Milton A2 - Macias, Charles G. A2 - Sharieff, Ghazala Q. A2 - Yamamoto, Loren G. PY - 2014 T2 - Strange and Schafermeyer's Pediatric Emergency Medicine, 4e AB - Small children with a clavicle fracture may present with refusal to move the arm after a fall.Children are more likely to suffer a Salter–Harris type II fracture separation of the proximal humerus than a true shoulder dislocation.Indirect radiographic evidence of elbow fracture includes the presence of a posterior fat pad, an exaggerated anterior fat pad, and an abnormal radiocapitellar or anterior humeral line.Supracondylar fractures of the humerus can be associated with acute and delayed neurovascular compromise and require immediate orthopedic consultation.Fracture of the radius or ulna requires x-ray evaluation of the elbow and wrist to determine if a Monteggia or Galeazzi fracture is present.The normal cascade of the resting hand shows increasing flexion from the index to little fingers and from the distal interphalangeal (DIP) joints to the metacarpophalangeal (MCP) joints. Deviation from this normal cascade implies a tendon laceration.A Salter–Harris type I or II fracture of the distal phalanx may not be seen on x-ray. Look for a mallet deformity and inability to extend the DIP joint.As in adults, scaphoid fractures are the most commonly encountered carpal fracture. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/04/16 UR - accesspediatrics.mhmedical.com/content.aspx?aid=1105681584 ER -