Author: Elizabeth Lewis, MD
Co Author #1: Andrew Porter D.O.
Senior Editor: Carolyn Landsberg, MD
Editor: Blake Corcoran, MD, CAQSM

Patient Presentation:
A 14-year-old male high school football player presented to clinic for follow up one day after sustaining a left wrist injury during an away football game.

History:
The mechanism of the injury was a fall on his outstretched arm. At the time of the injury, the patient reported pain and swelling of the dorsal, distal radius. He was treated by the athletic trainer. After the game, his mom took him to a local emergency room where x-rays were obtained. The patient was told he had a distal radius fracture, was placed in a short arm splint, and instructed to follow up with his local physician.

The next day, the patient presented to the sports medicine clinic. He reported continued pain, swelling and deformity to the left dorsal, distal radius and limited wrist range of motion. He had used ice, ibuprofen and acetaminophen for pain control. The x-rays from the emergency room were reviewed, and new x-rays were obtained.

Physical Exam:
Left forearm and wrist: Upon inspection, the patient had swelling, erythema and mild deformity to the dorsal, distal radius. He was tender to palpation at the distal radius and ulna; deformity was palpable at the dorsal, distal radius. Active wrist range of motion was decreased due to pain. Wrist flexion, extension, pronation, and supination strength was limited to 3/5 due to pain. Finger abduction and OK sign were 5/5 bilaterally. Sensation to light touch in the medial proximal forearm was slightly decreased but otherwise intact in the radial, median and ulnar nerve distributions.

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