Pediatrics Case 5 Diagnosis

Plain radiographs of the forearm are sufficient. The wrist and elbow should either be imaged to rule out associated fractures and dislocations. Occasionally, both-bone shaft fractures are associated with supracondylar humerus fractures, which creates a 'floating elbow' requiring surgical management. It is also important to assess radial head alignment to prevent a 'missed Monteggia' fracture pattern. Narcotic analgesia may be required to allow adequate positioning for true AP and lateral images.