RT Book, Section A1 Dietrich, Ann M. A1 Gould, Lindsay A2 Schafermeyer, Robert A2 Tenenbein, Milton A2 Macias, Charles G. A2 Sharieff, Ghazala Q. A2 Yamamoto, Loren G. SR Print(0) ID 1105681584 T1 Injuries of the Upper Extremities T2 Strange and Schafermeyer's Pediatric Emergency Medicine, 4e YR 2014 FD 2014 PB McGraw-Hill Education PP New York, NY SN 978-0-07-182926-7 LK accessemergencymedicine.mhmedical.com/content.aspx?aid=1105681584 RD 2024/04/24 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 x-ray 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 laceration.A Salter–Harris type I or II fracture of the distal phalanx may not be seen on x-ray. Look for a mallet deformity and inability to extend the DIP joint.As in adults, scaphoid fractures are the most commonly encountered carpal fracture.