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Here is another question that stumped me. Probably because I cannot read bone films.
A child falls with arms outstretched (according to Mom) and has pain and swelling of the dorsal wrist. A film is shown.
For anyone that remembers, what was the injury?
What is the treatment?
One of the treatment options was to call child protective services, but I didn't get the sense that the film showed evidence of child abuse.
Sorry I cannot be more specific about the vignette or answer choices.
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A 4-year-old girl is brought to the emergency department by her mother because of severe wrist pain. The girl was playing with her friends in her backyard and fell, breaking the fall with her outstretched hand. On physical examination there is slight swelling over the dorsal aspect of the wrist. X-ray films of the wrist are shown.
Item 1 of 2
17. The findings are most consistent with which of the following?
A
) Carpal navicular fracture
B
) Cortical fracture of the radius
C
) Fracture of the distal radius and ulnar growth plates
D
) Fracture of the distal radius growth plate
E
) Perilunate dislocation of the wrist
Item 2 of 2
18. Which of the following is the most appropriate management?
A
) Apply an elastic bandage and apply ice packs to the wrist
B
) Do closed reduction of the fracture
C
) Do closed reduction of the fracture and report the case to child protective services
D
) Immobilize the forearm and hand in situ in a cast
E
) Prepare for open reduction and internal fixation
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Photo:
Fracture of the distal radius growth plate
Salter-Harris fracture (growth plate fracture) type I
 Closed reduction treatment is usually sufficient for types I and II
 ORIF is often required for types III and IV [surgical repair]
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Thanks for the clarification/explanation.
