Both Bone Forearm Fracture - Pediatric Pathway Posted: 5/28/2020 ID: (C101479)

Both Bone Forearm Fracture in 15M

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PRESENTATION
4
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POLLS
389
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OUTCOMES
3
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VIDEOS
4
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EVIDENCE
13
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Comments
78
CASE DESCRIPTION
AGE 15 / Male
CC Left forearm deformity
HPI A 15-year-old male, left-hand-dominant, presents to the office after a fall on his outstretched left hand during a basketball game 2 weeks ago. He went to an outside ER and underwent a closed reduction with casting. He has remained in the cast since. Denies any numbness or tingling of the upper extremity.
PMH No prior medical issues or fractures
PE Lightly worn long-arm cast in place, compartments soft with a pink well perfused hand and all nerves intact. Cast index measures 0.95
Pre-procedure IMAGES:
https://upload.orthobullets.com/cases/101479/15a0686a-8f64-4119-a39c-2f3b0db8a5a5_injury_ap..jpg https://upload.orthobullets.com/cases/101479/731b5aea-5a43-4534-9bd2-f6a3c2bd4d45_injury_lateral..jpg https://upload.orthobullets.com/cases/101479/cbe1adc2-8181-4dd9-bb69-ab6d31f48a82_postop_red_ap..jpg https://upload.orthobullets.com/cases/101479/42a7665f-aa2e-446e-b5b5-4c14045f6957_post_red_lat..jpg
POLLS
OB Community
1) In addition to plain radiographs, would you obtain any additional imaging to guide management?
Other
2) How would you manage this injury?
Other
3) If you choose Nonoperative management, following the initial reduction at the outside ER, what would you do?
Other
4) If you choose Operative management, what would be your time frame to take him to surgery and where would you do it?
Other
5) If you choose Operative management, what would be your plan going into surgery?
Other
6) If you choose Flexible intramedullary nail fixation, which technique would you use?
Other
7) If you choose Flexible intramedullary nail fixation, how long do you immobilize the extremity postoperatively?
Other
8) If you choose Flexible intramedullary nail fixation, when would you schedule implant removal?
Other
CASE OUTCOMES
PROCEDURE 1: Closed reduction and percutaneous intramedullary flexible nailing of radius and ulna.
Post-procedure P1
https://upload.orthobullets.com/cases/101479/9591c746-1080-47bf-b3d3-50e11e76fcc2_intraop_reduction..jpg https://upload.orthobullets.com/cases/101479/0cefa42a-867e-4d03-a955-65c70e537394_intraop_wires_passing_ap..jpg https://upload.orthobullets.com/cases/101479/7198a9a5-8f07-4a70-93f3-70811c3f5b19_intraop_wires_lateral..jpg
VIDEOS & PODCASTS (4)
EVIDENCE (13)
EXPERT COMMENTS