Note the anterior and posterior sail signs. With this fracture one often sees no bony abnormality but the key is to look for the sail signs as evidence of underlying fracture, which can often only be seen on future xrays.
Given the absence of bony findings in many suprachondylar fractures in children, and the fact that sail signs can be somewhat subjective, what is the optimal approach to a child with an immobile, swollen elbow following trauma, yet with normal radiographs?
Taking a history of the injury and do a physical exam of the extremity noting any neurovascular compromise are the initial steps. Conservative management include analgesics and immobilization of the elbow in a flexion position. In cases of comparement syndrome or absent of pulse, orthopedics should be consulted. :)
Supracondylar fracture of the humerus:
ReplyDeleteNote the anterior and posterior sail signs. With this fracture one often sees no bony abnormality but the key is to look for the sail signs as evidence of underlying fracture, which can often only be seen on future xrays.
Given the absence of bony findings in many suprachondylar fractures in children, and the fact that sail signs can be somewhat subjective, what is the optimal approach to a child with an immobile, swollen elbow following trauma, yet with normal radiographs?
Taking a history of the injury and do a physical exam of the extremity noting any neurovascular compromise are the initial steps. Conservative management include analgesics and immobilization of the elbow in a flexion position. In cases of comparement syndrome or absent of pulse, orthopedics should be consulted. :)
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