Patient's Query
Hello doctor,
My son fell from the monkey bars at school. The diagnosis came back with three fractures and a displaced elbow. They placed a splint, and then we saw the orthopedic doctor. He said my son only has two fractures and ordered the cast below his elbow. I mentioned that his elbow hurt, and the doctor looked again and confirmed three fractures. He said there was nothing to worry about with the displaced elbow, and he did not reset anything. I am worried that he did not look closely enough and that I should get a second opinion. What would be the best course of action? My son will be 7 years old by next month.
Hello,
Thank you for the reply.
Yes, there are fractures of both the forearm bones and a fractured supracondylar bone of the humerus. I will recommend repeat X-rays of the elbow. In the lateral view of the elbow, the supracondylar does not look that displaced, but it is a little odd in the AP (anteroposterior) view. To confirm, a repeat X-ray needs to be done, and if still, any doubt persists, a few cuts of CT (computed tomography) will help.
Patient's Query
Hello doctor,
Thank you for the reply. The X-rays previously attached were the recent ones. I have attached all the pictures of the X-rays from the previous week. He broke his arm four days back, and they splinted it the same day. He was checked today for casting it. Does this help with the view? Should we obtain another set of X-rays or CT (computed tomography)? Also, I want to confirm whether the displacement is slight. Is a lateral condyle fracture in line with their diagnosis? Is the cast placed fine?
Hello,
Welcome back to icliniq.com.
I am afraid the X-rays did initially are not actual AP views, and in the lateral view, the elbow just happens to be there in the field. Therefore, I will recommend a second opinion to rule out lateral condyle fracture. If this is clinically and radiologically a supracondylar fracture, it does not need surgery and can be safely treated in a plaster slab. However, if it is a lateral condyle fracture and pain is absent on the medial condyle, it may need surgery.
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