PEDIATRIC DISTAL RADIUS FRACTURE

Question 1

Mechanism

Answer 1

FOOSH

Question 2

Physical Exam

Answer 2

Tenderness at the Distal Radius

Question 3

Radiologic Findings

Answer 3

Most commonly Buckle Fracture on the dorsal aspect
Ensure fracture is not “complete” aka “bicortical”
If tender + normal XRAY, consider Salter I fracture

Question 4

Concomitant Injuries

Answer 4

Salter II Fracture

Question 5

Management: “Simple” dorsal buckle fracture

Answer 5

Stable
Immobilize in posterior slab 2-3 weeks
Follow up with ortho

Question 6

Management: Complete buckle fracture

Answer 6

Potentially unstable
Immobilize well molded in flexion
Follow up with ortho in less than 1 week

Question 7

Management principles of angulated pediatric distal radius fracture: clinical appearance, age, direction of angulation, degree of angulation

Answer 7

Clinically apparent fracture - reduce
Age - younger children have more time to remodel
Direction of angulation - remodels well in the dorsal / volar plane NOT radial / ulnar plane
Degree of angulation - under 5, up to 50
5-10 up to 20
10-12 up to 10-15