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Figures A through E are injury radiographs of elbow injuries in children. A child complains of decreased sensation over the small finger acutely after an elbow injury. Which of the following radiographs is consistent with his injury?
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Following successful operative treatment, routine removal of hardware is recommended at 3-4 weeks for which of the following procedures?
A 7-year-old patient presents with a fracture of her left supracondylar humerus and distal radius as evidenced in Figure A. She is neurovascularly intact and the skin shows no evidence of open wounds. Radiographs of the elbow show a displaced supracondylar fracture. Radiographs of the wrist show an extra-articular distal radius fracture with 25 degrees of dorsal angulation. This injury is most appropriately treated with which of the following?
Closed reduction and casting of the supracondylar humerus fracture and distal radius fracture
Closed reduction and pinning of both the supracondylar humerus fracture and distal radius fracture
Closed reduction and casting of the supracondylar humerus fracture and pinning of distal radius fracture
Open reduction and pinning of both the supracondylar humerus and the distal radius fracture
Closed reduction and pinning of the supracondylar humerus fracture and closed reduction and casting of distal radius fracture
Which of the following elbow apophyses is the last to fuse during growth?
External (lateral) epicondyle
Internal (medial) epicondyle
A child falls off of the monkey bars at school and sustains the left elbow injury shown in Figure A. What is a disadvantage of the fixation construct shown in Figure B compared to Figure C for this injury pattern?
Less biomechanical stability
Higher incidence of compartment syndrome
Higher chance of osteomyelitis
Higher risk of iatrogenic injury to the ulnar nerve
Higher risk of iatrogenic injury to the anterior interosseous nerve
What is the advantage of medial and lateral crossed pins compared to two lateral pins in the treatment of supracondylar humerus fractures?
Greater ultimate clinical arc of elbow motion
Lower revision rate
Lower incidence of ulnar nerve injury
Greater experimental biomechanical stability
More anatomic fracture reduction
A 7-year-old boy falls off the playground and sustains the injury shown in figure A. What motor deficit is associated with the nerve most commonly injured in this fracture pattern?
Weakness of the flexor digitorum profundus to the index finger
Weakness of the extensor pollicis longus
Weakness of the flexor pollicis longus
Hand intrinsic weakness
What is the etiology of cubitus varus following a supracondylar humerus fracture in a child?
Overgrowth of the lateral physis
Malreduction of the fracture
Growth arrest of medial physis
Injury to the ulnar nerve
Radial head dislocation
A 10-year-old boy sustained the injury shown in figure A while jumping off a trampoline. His hand is pulseless and cold. What is the next step in management?
Loose-fitting splint application and reassess in 1 hour
Emergent closed reduction and pin fixation
Open vascular exploration
Forearm skeletal traction pin
A 5-year-old boy sustains a type II (Gartland classification) supracondylar fracture which is treated with cast immobilization. Healing results in a mild gunstock deformity. Surgical treatment of this will most likely result in:
improved functional outcome
improved pain relief
improved range of motion
reduce non-union rates
The most common nerve injured in the fracture shown in Figure A innervates all of the following muscles EXCEPT?
flexor digitorum profundus index finger
flexor digitorum profundus middle finger
flexor pollicis longus
extensor pollicis longus
A 8-year-old boy has a cubitus varus deformity of his left elbow after a supracondylar humerus fracture was treated in a splint. What is the most common cause of this deformity?
Malreduction causing malunion
Medial epicondyle growth arrest
Lateral condyle overgrowth
Medial epicondyle avascular necrosis
Unrecognized compartment syndrome
Howard A1, Mulpuri K, Abel MF, Braun S, Bueche M, Epps H, Hosalkar H, Mehlman CT, Scherl S, Goldberg M, Turkelson CM, Wies JL, Boyer K; American Academy of Orthopaedic Surgeons.
J Am Acad Orthop Surg. 2012 Feb;20(2):69-77. PMID: 22553104 (Link to Abstract)
Supracondylar Humerus Fractures In Children-Coleen Sabatini ,MD,MPH (COA 2017,...
Supracondyar fractures are common and often subtle paediatric elbow fractures. T...
Lateral entry percutaneous pinning of a SCH fx
HPI - no pain. only cosmetic deformity is concerned for surgical correction
How would you treat this deformity?
HPI - A 6-year-old box presents with elbow pain immediately following a fall from bed with an outstretched hand at home.
How would you treat this injury?
HPI - History of fall 2days back resulting in closed supracondylar fracturewith vascular compromise .Gross swelling was present. Radial artery was not palpable. doppler study was not able to pick the pulses.Immediate closed reduction and percutaneous k wire fixation was done .cyanosis was restored and oxygen saturation was about 98 percent .doppler study showed both radial and ulnar pulses to be ok.
Post op x rays were not satisfactory .it has been 2 days post op ,swelling has decreased.
I am not satisfied with my initial closed reduction and percutaneous pinning. What should be the next course of action considering there is gross swelling and vascular compromise?