Musculoskeletal damage: what is the difference in children? Pain in the forearm due to a fall

Abstract

This 5-year-old male was doing everything that all children do. He was having fun, horsing around, then all of sudden, he fell. After he fell he experienced pain in the left upper extremity. Because of this he was brought to our Emergency Care facility. Upon arrival he was in good health and all of his vital signs were normal. He was in no acute distress but he did seem to hold his left upper extremity in a guarded position. On physical examination no abnormalities were detected except those related to the left upper extremity. On clinical inspection there was mild soft tissue swelling over the forearm and on physical examination there was concomitant tenderness of the left forearm. There was no deformity of the upper extremity and the physical findings did not seem to focus on the elbow or the wrist. No other abnormalities were detected and thus radiographs of the left upper extremity, with comparative views of the right side, were obtained (Fig. 1). What do you think? Is there a fracture present?