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Pediatric Fracture Management

From Appropedia

Module Authors: Jennifer Best, Pedro Campos, Andrew Chang, Jaspreet Randhawa

This module was created as part of a course deliverable for the Master's of Medical Sciences (MMSc) in Medical Education program at the Harvard Medical School.


Self-Assessed Learning Module

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Clinical Case Scenario

A 16-year-old female patient accompanied by her mother presents to the Emergency Department two days after sustaining a fall while playing soccer, during which she extended her hand to break the fall. The patient describes experiencing sudden-onset pain in her left wrist immediately following the incident. The pain has persisted since then, resulting in limited range of motion due to discomfort. She denies experiencing any other symptoms.

Physical examination is remarkable for moderate swelling and bruising present over the L distal forearm with painful movements of the wrist and elbow. Neurovascularly intact.

Radiographs are obtained from the patient.

Please see the initial X-Ray results on the right side of this page.

Round One

1

Please evaluate the patient's radiograph:

Abnormal
Normal
Indeterminate

2

Does this patient require additional imaging?

Yes
No

3

If yes, what additional imaging will this patient need?

Lateral view X-Ray
CT
MRI
Other

4

Based on a review of the radiograph, the patient has a

displaced fracture
non-displaced fracture

5

What is the articular status of the fracture?

extra-articular
intra-articular

6

The fracture is located in the...

Radius
Ulna
Wrist bones
Metacarpals

7

Is the Salter-Harris classification applicable? If yes, what is the Salter-Harris classification?

I
II
III
IV
V
Not Applicable

8

Is a surgical referral necessary?

Yes
No

9

Does the patient need casting?

Yes
No

10

If yes, the type of cast we will use is called a ...

Long Arm Cast
Short Arm Cast

11

Does the patient need splinting?

Yes
No

12

If yes, the specific type of splint we will use is called a...

coaptation splint
sugar tong splint
posterior long arm elbow splint
ulnar or radial gutter splint
volar or dorsal short arm splint
thumb spica splint

13

We will repeat the imaging in...

1 week
2 weeks
3 weeks
4 weeks

14

We will see you in the clinic for a follow up visit in...

1 week
2 weeks
3 weeks
4 weeks

Round Two

Syntax error

1

Please evaluate the patient's new radiograph:

Abnormal
Normal
Indeterminate

2

Does this patient require additional imaging?

Yes
No

3

If yes, what additional imaging will this patient need?

Lateral view X-Ray
CT
MRI
Other

4

Based on a review of the radiograph, the patient has a

displaced fracture
non-displaced fracture

5

What is the articular status of the fracture?

extra-articular
intra-articular

6

The fracture is located in the...

Radius
Ulna
Wrist bones
Metacarpals

7

Is the Salter-Harris classification applicable? If yes, what is the Salter-Harris classification?

I
II
III
IV
V
Not Applicable

8

Is a surgical referral necessary?

Yes
No

9

Does the patient need casting?

Yes
No

10

If yes, what type of cast?

Long Arm
Short Arm

11

Does the patient need splinting?

Yes
No

12

If yes, the specific type of splint we will use is called a...

coaptation splint
sugar tong splint
posterior long arm elbow splint
ulnar or radial gutter splint
volar or dorsal short arm splint
thumb spica splint


Please click on the page link below for a case summary and feedback form!


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License CC-BY-SA-4.0
Language English (en)
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Views 225 page views (analytics)
Created April 22, 2024 by 142.117.4.158
Last edit May 5, 2024 by StandardWikitext bot
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