5 year boy –
1- x ray 5 day after fracture
2- xray after closed reduction
3- xray after 7 day of close reduction
4- x ray after 12 day of close reduction …
1- x ray 5 day after fracture
2- xray after closed reduction
3- xray after 7 day of close reduction
4- x ray after 12 day of close reduction …
- A 4 personas les gusta esto.
Somnath Chowdhury clearly, there is too much wool inside the cast, hence the cast is not well fitted. u hv to re-manipulate and re-do the cast. since, this is a volar angulation, cast shud be in prone position.
- Balvinder Singh 5 years old closed reduction is only the choice !i dont knw abt uk !!! wht they do plating in 5 years old or wht ???:)
- Harish Kurup I meant we will not do anything in UK other than putting a plaster in clinic for this one !!! I was just questioning the need for closed reduction to start with!
- Somnath Chowdhury if u hav done CR once, and there is loss of reduction, wud u not do a re-MUA and rectify the deformity? @Ibrahim Najjar
Manoharan Muthulingam I think X ray shows that pop is cylinder in shape. U must redo CMR and put pop then make the cylinder pop to oval pop.
- Anoop R. Nair @ Somnath what’s your take on remodeling in such age group .. Does it need anatomical reduction ?
- Somnath Chowdhury if the initial xray was good enough for a closed manipulation, then the 12day xray shud also be corrected by closed reduction.
- Gopal Goel Ibrahim Najjar leave it alone . This much angulation will disappear in 3-6 months with full ROM
Pravin Kanabar This seems to be a greenstick fracture. It seems to be immobilized in mid pron. These fractures need derotation and then to be put in a cast. Having done this, will prevent deformity. This was well taught to me by Late Mr. J. H. S. Scott of P.M. R. Hospital of Edinburgh. He ussed to emonstrste this by match stick example.
Ahmad Fukhaidah Good job cont on conservative management and will be good alignment and good remodeling
Osama Sami Alkayar For the reduction it is acceptable, cause angulation until 30 degree in this site and below 10 years will corrected by remodeling, but my concern about the position of wrist joint in th POP, it must be in 30 degree extend position. About the case you well done need just further one week in POP then POP below elbow for 2 weeks.
Rupal Patel Definitely non operative. The reason it did not hold reduction is cast index > 0.8 . As Dr Manoharan Muthulingam mentioned in simple words.
Ramiro Trujillo Gonzalez The cast is too loose, is likely cause loss of reduction, I suggest changing the cast by one more tight and above the elbow to control the PS and and correct the position of the wrist.
Jwalant Mehta Swelling ha reduced. Cast is loose. Re manipulate under ga and apply a well moulded cast….above elbow
