Module 54, General Medical Level

A 12 year old right hand dominant female presented to the emergency room complaining of right forearm pain. The patient stated that while playing basketball she fell down and another player subsequently fell onto her right arm. Physical exam revealed an alert white female. The volar surface of the proximal forearm had two small puncture wounds. Radiographs revealed a comminuted fracture of the proximal one-third of the ulna with over-riding of the fragments. The radial head was dislocated anteriorly.

Question 54A

An examination of the girl's arm should include careful documentation of function of the finger flexion and extension.

---

Question 54B

An intervenous line should be started and she should receive 1 gram of cephlethin.

---

Question 54C

These puncture wounds on the forearm need to be cleaned with alcohol and a bandaid applied before placing the child in a cast after the closed reduction.

---

Question 54D

The elbow also has a dislocation.

---

Question 54E

This is a common fracture pattern for this age child.

Go to Next Question Module, Go to General Orthopaedist Level Modules, Go to Question Module Home Page, Go to Case Presentation Home Page, Orthopaedic Department Home Page.