14 year male. Pre and post reduction x-rays
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Mathew P.thomas Absolutely no conservative management . Eithr stout k wires intramedullary or plate osteosynthesis… -
Arvind Jain At the best Sir…Hats off….a below elbow slab for 10 days and POP for next two weeks is all one needs at this age.Not o forget inclusion f thumb in plaster.Conservative for sure is complication free. -
Pritish Singh Sir, this fracture level(at this age) has a strange incidence of re fracture after initial union- k wires are difficult to pass at this level. I would plate it avoiding physis. -
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Mathew P.thomas 5 deforming forces act on the distal fragment…age of fixation has come down to 12 yrs..absolutely no below elbow..ae may work if u r goin 4 conservative..but regular follow up required
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Pritish Singh By giving BE cast, even prono-sup cannot be controlled in this highly unstable #.Im sorry sir,I do not agree to this treatment.
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Arvind Jain There must be some misbelief about BE plaster,this happens when you apply adult fracture principles in children.It will displace only if sling is given.
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Mathew P.thomas Sir can u plz explain how sling makes the difference?sir y s tat brachioradialis and pron quadratus act in adults and not in children if so?
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Prasad Pidikiti Surgeon who did the MUA should be the better judge of further management. He is the only one who knows the stability after reduction, not the ones seeing the films on facebook.
By nature bothbone forearm fractures are unstable if they are at the same level.
If at MUA reduction is stable POP is enough. If not stable then supplement reduction with fixation -
Arvind Jain dr Mathew P.thomas – vertically hanging arm keeps reduction,just as you hang a chain and all shackles remain in line.See how sling deforms by gravity sagging
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Arvind Jain and this recent case -How simple it is..only in child when BE plaster chosen in place of AE……Some people advocate AE plaster for colles’ too,but every one knows ,its not needed.
