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The patient is a 2½-year-old female who presented after falling, unobserved, from an unknown height with tenderness and swelling around the elbow.
Neurovascular exam was normal.
View the x-ray taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
Resulotion
The correct diagnosis is a supracondylar fracture; note the loss of the normal angle at the distal humerus.
The injury was managed with a posterior splint in flexion, with follow-up the next day with an orthopedist.
Acknowledgment: Case presented by Nahum Kovalski, BSc, MDCM; the patient was treated by Dr. Elinor Vandermarva.
Clinical Challenge: May, 2007
