TENS

Mechanism

FOOSH

- valgus injury

- don't get radial head fracture as is mostly cartilaginous

Types

SH 1 or 2

Associated Injuries

MCL injury

Olecranon / Medial epicondyle fracture

Types

Age 0 - 5

- Salter Harris I

Age 5 - 11

- Salter Harris II

III / IV rare

Issues

Great remodelling potential

- 80% growth of humerus from proximal physis

Shoulder ROM compensatory

Age

- even older adolescents do well

Ossification

Primary

- 8 / 52 gestation radius & ulna

Secondary

- distal radius age 1

- distal ulna age 5

Non Operative Management

Unacceptable Position

< 10:  > 15^o malalignment

> 10:  > 10^o malalignment

Postreduction Positionin / Rule of Thirds 

Aetiology

Varies per age group

Trauma

- 60%

Non Accidental Injury

- 15 - 30%

- suspect if non walker / < 1 year

- walking status single best indicator of risk

- paediatric team to investigate

- history taking from parent

- consider metabolic investigations