2.  10 yo boy presents with
obvious deformity to right
wrist after football injury.
Ice was placed at the scene
and he was given ibuprofen
for pain by EMS. No other
complaints or injuries
reported. He has no other
health problems.
 T:99.1 P:94 O2: 99%
 BP: 130/80 R:18
 Gen: NAD
 HENT: no traumatic abn
 CV/Resp: CTA, RRR
 MSK obvious deformity to
R wrist
 Ext: 2+ radial pulse, U/R/M
nerves intact to sensation
and motor, good cap refills,
TTP in region of wrist and
distal forearm

4. P
M
Clear fracture seen
transversing from
physis through
metaphysis
Also, transverse
fracture of ulna

5.  Good neurovascular exam
 Reduce significant angulation or obvious deformity in
combination with good analgesia +/- hematoma block.
 If open, abx and in-house ortho consult.
 With adequate reduction, splint and FU with ortho.
 Repeat neurovascular exam after splinting.

6.  Salter Harris Type II fracture extends from the
metaphysis through the physis with the entire
epiphysis and part of the metaphysis being broken off.
 Most common Salter Harris fracture
 Typically occurs after age 10
 Rarely results in functional limitation

8.  http://emedicine.medscape.com/article/412956-
overview
 http://www.feinberg.northwestern.edu/emergencyme
d/residency/ortho-
teaching/pediatrics/case23/case23additionalimages.ht
ml
 http://www.hawaii.edu/medicine/pediatrics/pemxray/
v1c18.html
 http://www.wheelessonline.com/ortho/sh_type_ii
 Menkes, J.S. Orthopedic Injuries. Tintinalli’s
Emergency Medicine: A Comprehensive Study Guide
Chapter 267