A 7-year-old boy presents to a regional ED, triage category 2, after a fall onto an outstretched hand. X-ray shows displaced supracondylar fracture.

Question

A 7-year-old boy presents to a regional ED, triage category 2, after a fall onto an outstretched hand. X-ray shows displaced supracondylar fracture. The hand is pale and cool with absent radial pulse, but median nerve sensation is intact. What is the most appropriate management?

Accepted Answer

Urgent orthopaedic reduction with neurovascular monitoring

Answer

Apply circumferential cast and review next week

Answer

Perform outpatient CT angiography before referral

Answer

Discharge in a sling

Answer

Give oral antibiotics and observe

Supracondylar fracture with vascular compromise — ACEM Fellowship MCQ

A 7-year-old boy presents to a regional ED, triage category 2, after a fall onto an outstretched hand. X-ray shows displaced supracondylar fracture. The hand is pale and cool with absent radial pulse, but median nerve sensation is intact. What is the most appropriate management?