RT Book, Section A1 Stoner, Michael J. A1 Dietrich, Ann M. A2 Tenenbein, Milton A2 Macias, Charles G. A2 Sharieff, Ghazala Q. A2 Yamamoto, Loren G. A2 Schafermeyer, Robert SR Print(0) ID 1155296226 T1 Injuries of the Upper Extremities T2 Strange and Schafermeyer's Pediatric Emergency Medicine, 5e YR 2019 FD 2019 PB McGraw-Hill Education PP New York, NY SN 9781259860751 LK accessemergencymedicine.mhmedical.com/content.aspx?aid=1155296226 RD 2024/10/16 AB Small children with a clavicle fracture may present with refusal to move the arm after a fall.Children are more likely to suffer a Salter–Harris type II fracture separation of the proximal humerus than a true shoulder dislocation.Indirect radiographic evidence of elbow fracture includes the presence of a posterior fat pad, an exaggerated anterior fat pad, and an abnormal radiocapitellar or anterior humeral line.Supracondylar fractures of the humerus can be associated with acute and delayed neurovascular compromise and require immediate orthopedic consultation.Fracture of the radius or ulna requires radiograph evaluation of the elbow and wrist to determine if a Monteggia or Galeazzi fracture is present.The normal cascade of the resting hand shows increasing flexion from the index to little fingers and from the distal interphalangeal (DIP) joints to the metacarpophalangeal (MCP) joints. Deviation from this normal cascade implies a tendon injury until proven otherwise.A Salter–Harris type I or II fracture of the distal phalanx may not be seen on radiograph. Look for a mallet deformity and inability to extend the DIP joint.As in adults, scaphoid fractures are the most commonly encountered carpal fracture.