8/4/2023 0 Comments Grading supracondylar fracture![]() Is the hand perfused? Check capillary refill time and temperature.is the skin in the antecubital fossa threatened? If there is skin stretched over a spike of bone, this may become necrotic within hours Is the injury closed or open? The only sign of an open fracture may be a pinprick wound in the antecubital fossa.Ask carefully about head injury and try to elicit whether there are any concerns of non-accidental injury (NAI). AMPLE (allergies, medications, past medical history, last food/drink and events leading to injury) provides a useful template. Initial assessmentĪs always, if you have any concerns regarding high energy trauma, assess with an ATLS approach.Ĭheck distal perfusion early (skin colour, temperature and capillary refill, radial pulse), and call a senior immediately if the hand is ischaemic (no pulse and impaired perfusion). Most SCHs are relatively benign and can wait until the morning/next day for definitive treatment, but occasionally the neurovascular structures around the elbow can be injured, requiring urgent treatment to reduce the risk of permanent disability. Bruising in the antecubital fossa is common. They will typically have a painful elbow, which may be deformed. fall from monkey-bars) having fallen onto an outstretched hand. All have their own peculiarities of management, but many of the principles of assessment can be applied from SCHs to these other injuries.Ĭhildren usually present following intermediate-energy trauma (e.g. Other less common injuries include physeal separation (Salter-Harris type injuries), media/lateral condyle fractures, dislocations, and radial head fractures. Supracondylar fractures of the humerus (SCHs) are the most common elbow injury in children. Admission, discharge and calling a senior
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