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A 6-year-old boy fell off the monkey bars 3 months ago and has had pain and decreased elbow motion since his fall. His radiographs are shown in figures A and B. Closed reduction was unsuccessful. What is the most appropriate treatment?
Bracing and early range of motion
Closed reduction and casting in supination and flexion
Open reduction internal fixation of medial epicondyle fracture
Open reduction internal fixation of lateral condyle fracture
Open reduction of radial head dislocation with casting in supination and flexion
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A 7-year-old girl falls off of her bike and sustains the injury depicted in Figures A & B. All of the following are indications for surgical management of Monteggia fractures EXCEPT:
Combined radius and long oblique ulnar fracture and reduced radial head dislocation
Incomplete ulnar fracture with lateral radial head dislocation that is successfully reduced
Ulnar communition with ulnar shortening
One week post-reduction/casting radiograph showing loss of radial head reduction
Long oblique ulnar fracture with irreducible radial head dislocation
A 4-year-old girl sustains a buckle fracture of the ulna and associated radial head dislocation. Closed reduction and immobilization of the arm in 110 degrees of flexion (as swelling allows) and full supination enhances the stability of the injury by which of the following:
Tightening the interosseous membrane
Tightening the biceps
Eliminates plastic deformation
Relaxes the pronator quadratus
Protects the posterior interosseous nerve
This video describe the clinical presentation and XR findings in Monteggia fract...
HPI - 12 yo boy presents with Left elbow pain and a history of an ulna shaft fracture 3 years ago.
He was treated with closed reduction and casting at the time of the initial injury. The boy's parents report that his arm never looked right after the injury. He continued to have pain in the lateral aspect of his elbow, with an associated prominence anterolaterally. They were advised to wait two years which did not yield significant improvement, so they finally sought treatment elsewhere.
The patient presents with his parents with complaints of left elbow pain with movement and inability to participate in sports. The patient is right hand dominant and this is a left-sided injury.
Only one XRay is available from the initial injury, which is shown.
Three current XRays are shown.
Would you order further imaging on this patient?
HPI - Patient presented after a fall from a slide on his left arm. Patient denied any other trauma. Patient's parents think he fell on an outstretched arm.
What is the most likely diagnosis?
HPI - pai and limitation of elbow since 2 years
How would you treat this patient