RT Book, Section
A1 Stoner, Michael J.
A1 Dietrich, Ann M.
A2 Tenenbein, Milton
A2 Macias, Charles G.
A2 Sharieff, Ghazala Q.
A2 Yamamoto, Loren G.
A2 Schafermeyer, Robert
SR Print(0)
ID 1155296226
T1 Injuries of the Upper Extremities
T2 Strange and Schafermeyer's Pediatric Emergency Medicine, 5e
YR 2019
FD 2019
PB McGraw-Hill Education
PP New York, NY
SN 9781259860751
LK accesspediatrics.mhmedical.com/content.aspx?aid=1155296226
RD 2024/04/19
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  radiograph  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  injury  until  proven  otherwise.A  Salter–Harris  type  I  or  II  fracture  of  the  distal  phalanx  may  not  be  seen  on  radiograph.  Look  for  a  mallet  deformity  and  inability  to  extend  the  DIP  joint.As  in  adults,  scaphoid  fractures  are  the  most  commonly  encountered  carpal  fracture.