Conference Extern ธนินท์ธร  

1. Orthopedic conference
Tanintorn Pootrakul
6th Year medical student
Ramathibodi hospital

2. Case
Patient profile
ผู้ป่ วยเด็กชาย ไทย อายุ 4ปี 6เดือน ภูมิลาเนา นครราชสีมา
Chief complaint
ข้อมือขวางอผิดรูป 7 ชั่วโมงก่อนมารพ.

3. Primary survey Second survey
Head to toe
examination
process

4. 1.
Primary Survey
A : can speck, can flex neck, no facial swelling, not tender in
posterior midline of neck
B : trachea in midline, normal breath sounds, equal both lungs
C :BP100/60 mmHg HR116/min
D : E4V5M6 pupil 2 mm RTLBE
E : deformity at right wrist, limit ROM, contusion at right
foerhead

5. Secondary survey
■ S : ข้อมือขวางอผิดรูป7 ชั่วโมงก่อนมารพ.
■ A : no history of food and drug allergy
■ M : no current medication
■ P : no underlying disease
■ L : last meal 8 hoursPTA
■ E : ผู้ป่วยเสียจังหวะขณะเล่นม้วนตัว7 ชั่วโมงก่อนมารพ. ทับแขนขวาตัวเอง ข้อมือ
ขวางอผิดรูป มีรอยฟกช้าบริเวณหน้าผากด้านขวา ไม่สลบ ไม่ได้รับบาดเจ็บบริเวณอื่น
มารดาจึงรีบพามาโรงพยาบาล

6. Head to Toe examination
■ GA: A Thai boy , good concious , well cooperate
■ HEENT: not pale conjunctivae, anicteric sclerae, contusion
size 3 cm at right forehead, no active bleed
■ Heart: normal s1s2, no murmur
■ Lungs: normal breath sounds, equal both lungs
■ Abdomen: soft, not tender, normoactive bowel sounds
■ Neurological: E4V5M6, pupil2mm RTLBE
■ Extremities:
Rt.wrist-defomity , marked swelling, tender, limit ROM,
radial pulse 2+, nerve intact , good capillary refill

8. Yellow
Is the color of gold,
butter and ripe
lemons. In the
spectrum of visible
light, yellow is found
between green and
orange.
Blue
Is the colour of the
clear sky and the deep
sea. It is located
between violet and
green on the optical
spectrum.
Red
Is the color of blood,
and because of this it
has historically been
associated with
sacrifice, danger and
courage.
In two or three columns

9. 1. Pethidine 20 mg IV stat
2. Close reduction with AP long arm slab
Management

10. Pediatric and
adolescent
forearm fracture

11. Treatment
goal
General
considerations
Treatment
Topic

12. 89,526,124$
That’s a lot of money
100%
Total success!
185,244users
And a lot of users

13. Noonan and Price

14. 1. lenght
2. alignment
3. rotation
Treatment goal

15. Treatment
■ Closed reduction and casting
■ Surgical
- intramedullary nail
- plate osteosynthesis
Indication
1. Unacceptional reduction
2. loss of reduction
3. Fx in1-2 years old
4. Open fracture
5. Pathologic fx
6. Floating elbow
7. Neurovasucular injury

17. Yellow
Is the color of gold,
butter and ripe
lemons. In the
spectrum of visible
light, yellow is found
between green and
orange.
Blue
Is the colour of the
clear sky and the deep
sea. It is located
between violet and
green on the optical
spectrum.
Red
Is the color of blood,
and because of this it
has historically been
associated with
sacrifice, danger and
courage.
In two or three columns