2.  10 yo boy presents with  T:99.1 P:94 O2: 99%
obvious deformity to right  BP: 130/80 R:18
wrist after football injury.
Ice was placed at the scene
and he was given ibuprofen  Gen: NAD
for pain by EMS. No other  HENT: no traumatic abn
complaints or injuries  CV/Resp: CTA, RRR
reported. He has no other
health problems.  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. Clear fracture seen
transversing from
P
physis through
M
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