A child will complain of pain and swelling over the elbow immediately post trauma with loss of function of affected upper limb. Late onset of pain (hours after injury) could be due to muscle ischaemia (reduced oxygen supply). This can lead to loss of muscle function. It is important to check for viability of the affected limb post trauma. Clinical parameters such as temperature of the limb extremities (warm or cold), capillary refilling time, oxygen saturation of the affected limb, presence of distal pulses (radial and ulnar pulses), assessment of peripheral nerves (radial, median, and ulnar nerves), and any wounds which would indicate open fracture. Doppler ultrasonography should be performed to ascertain blood flow of the affected limb if the distal pulses are not palpable. Anterior interosseus branch of the median nerve most often injured in postero-lateral displacement of the distal<unk>  as the proximal fragment is displaced antero-medially. This is evidenced by the weakness of the hand with a weak "OK" sign on physical examination (Unable to do an "OK" sign; instead a pincer grasp is performed). Radial nerve would be injured if the distal<unk>  is displaced postero-medially. This is because the proximal fragment will be displaced antero-laterally. Ulnar nerve is most commonly injured in the flexion type of injury because it crosses the elbow below the medial epidcondyle of the<unk> . A puckered, dimple, or an ecchymosis of the skin just anterior to the distal<unk>  is a sign of difficult reduction because the proximal fragment may have already penetrated the brachialis muscle and the subcutaneous layer of the skin. Complications Volkmann's contracture Swelling and vascular injury following the fracture can lead to the development of the compartment syndrome which leads to long-term complication of Volkmann's contracture (fixed flexion of the elbow, pronation of the forearm, flexion at the wrist, and joint extension of the metacarpophalangeal joint ). Therefore, early surgical reduction is indicated to prevent this type of complication. Malunion The distal<unk>  grows slowly post fracture (only contributes 10 to 20% of the longitudinal growth of the<unk> , therefore, there is a high rate of malunion if the<unk>  fracture is not corrected appropriately. Such malunion can result in cubitus varus deformity.
Supracondylar humerus fracture
Radial head fracture
Proximal humerus fracture
Jefferson fracture
Bosworth fracture
Scapular fracture
Scaphoid fracture
Cuboid fracture