7 year old child with gross swelling, Neuro vascular status normal. Management protocol?
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Shailendrasingh Thakur Gross swelling…..put Dunlop’s traction till swelling subsides. Then go for close reduction. sos stabilisation with k wire.
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Atef Ortho Ortho Slipped lower humeral epiphysis .. very rare in this age . Can be treated same as supracondylar fracture humerus .. closed reduction with pinning or orif with pinning if closed redution fails
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Rajeev Nirawane Distal humerus physeal separation. to be treated like supracondylar as said by dr Atef. Swelling wont subside unless one reduces it. key to differentiate from lateral condyle is to look for the radiocapitellar alignment. its disturbed in lateral condyle # maintained in physeal separation
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Rakesh Agarwal this is epiphyseal separation with postero latera dislocation elbow, reduce it as early as possible may be open reduction if required and k wire fixation for fixation of lateral condyle
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Atef Ortho Ortho The x ray is diagnostic . In x rays like this We have 3 conditions that should be diffrentiated from each others . 1. Fracture lateral humeral condyle
2. Slipped lower humeral epiphysis
3. Elbow dislocation
The first 2 conditions had been diffrentiated nicely by dr Rajeev .no 3 .. you will find capitillum in its place in lower humerus and possible radioulnar dissociation . -
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Alhamwi Talal Closed reduction then fixation with 2 K wires from lateral side… if not good reduction ORIF Kwires
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Mithilesh Kumar Fracture lateral condyle. Reduce it by giving traction.apply pop slab .after 4days go for open reduction through lateral approach and apply two k wires 2mm