You are on duty in the ED when the paramedics bring in a patient from the county jail who had tried to hang himself. When the patient arrives, you are told by the accompanying guard that the patient was found with a tightly twisted bedsheet around his neck and looped over the bedpost of the metal bunkbed.
Although lower extremity fractures are much less common than upper extremity fractures in children, the correct diagnosis and management of this type of injury is critical. In the second part of this series the authors review common lower extremity fractures, fractures common in abused children and the diagnosis and treatment of radial head subluxation. Children are much more likely to sustain fractures rather than ligamentous injuries and identification of injuries and timely management will maximize an optimal outcome. Awareness of certain unique pediatric fractures such as the triplane juvenile fracture and the juvenile Tillaux fracture will allow for prompt treatment and referral. The authors also provide a table encompassing guidelines for ED management and treatment of common pediatric orthopedic injuries.
