Pediatric emergency medicine trisk 3453 3453
Bạn đang xem bản rút gọn của tài liệu. Xem và tải ngay bản đầy đủ của tài liệu tại đây (132.78 KB, 1 trang )
old, with a peak incidence between ages 5 and 7 due to the relative strength of the
collateral ligaments and joint capsule as compared to the bone.
FIGURE 111.16 Normal lateral radiograph of the elbow of a 2-year-old child. The anterior fat
pad is readily seen (arrow ); the posterior fat pad is not visible. A line drawn along the anterior
cortex of the humerus intersects the capitellum in its middle third (solid line ). A line drawn
along the axis of the radius also passes through the center of the capitellum (dashed line ).
Clinical assessment . Supracondylar fractures commonly present with localized
swelling and tenderness around the elbow on examination, with or without
deformity of the distal humerus. The presence of extensive swelling and
ecchymosis of the elbow imparts a significant risk for compartment syndrome.
Any progression of increasing pain, or pain with passive extension of the fingers
is concerning for ischemia and requires immediate orthopedic consultation. A
thorough examination of perfusion as well as motor and sensory function of the
median, radial, and ulnar nerve distribution is essential ( Table 111.6 ) as nerve
injuries are present in up to 15% of injuries and vascular compromise
approaching 20% of injuries. The median nerve—specifically the anterior
