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Pulseless supracondylar fracture — RCPSC EM MCQ

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HardMusculoskeletalPulseless supracondylar fractureRCPSC EM

A 7-year-old falls from monkey bars and has a displaced supracondylar humerus fracture. The hand is pale and cool with absent radial pulse, but median nerve function is difficult to assess due to pain. What is the most appropriate next step?

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Correct answer: A — Urgent orthopaedic reduction and vascular reassessment

A pulseless, poorly perfused hand after displaced supracondylar fracture is an orthopaedic emergency requiring urgent reduction and reassessment of perfusion and nerve function.

Reference: Canadian Paediatric Orthopaedic Group practice; emergency medicine consensus