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11 year old Alex is brought to the ER with history of a fall on his…
11 year old Alex is brought to the ER with history of a fall on his outstretched right hand while playing football in school
Presenting complaint:
Pain, swelling, change in shape and inability to move his right wrist since the fall 4 hours ago.
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General examination:
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Conscious, cooperative, pleasant, oriented to time and place
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Local examination:
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Overlying skin: Intact, no wounds, induration or scars.
The Right upper limb was immobilized temporarily in an above elbow back-slab and a series of X-rays were ordered for the patient.
X-ray of the Right wrist PA and LAT Views with Salter-Harris type II growth plate injury in the distal radius and DRUJ disruption.
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Elective closed reduction and fluoroscopy guided percutaneous pinning with K-wires of the Right radius and cast application, under GA.
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He was sent home with a bi-valved above elbow cast with K-wires in situ with instructions for plaster care, antibiotic prophylaxis.
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On the 10th Post-op day, follow up X-rays showed adequate reduction and healing.
The cast was converted to a below elbow cast to allow for physiotherapy and mobilization of the elbow.
6 weeks after the surgery, the K-wires were removed, and patient was advised to undergo extensive physical therapy of the right upper limb.