Interesting...maybe a case report there Charles!
Happy Christmas to the list...hope you are all not working
too much.
Andy Webster
On Thu, 21 Dec 2006 12:31:50 -0000
"Scott, Charles"
<[log in to unmask]> wrote:
> We have just had a case where a 25 year old woman was
>hit on the forearm
> and she sustained a "defensive" injury of the distal
>ulna. She had
> local tenderness on the distal ulna only with no other
>bony tenderness.
> Xray was normal, so she was discharged. 3 days later
>she attends St
> Elsewhere's because the arm is still very sore and they
>find this.
>
>
>
>
>
>
>
>
>
> Even with hindsight the original film is normal. We
>know these things
> happen but what is the scientific reason the fracture
>doesn't show on
> the original film taken on the day of injury? And how
>often should we
> re-xray patients who complain that the limb still hurts?
> We are
> familiar with the scaphoid scenario but should this
>apply to all
> fractures? I think not as this is a rare occurrence,
>but still going to
> cause us trouble via the complaints procedure. The
>exception is I
> think patients who return with pain in the hip; we
>always re-xray hips
> as fractures are well known to show late. Is it that
>the ulna injury
> is a variety of stress fracture which are notorious as
>only showing on
> X-ray after a few weeks, but why should a single blow to
>the forearm be
> a stress injury?
>
>
>
> I am reminded of the cartoon boulders which when hit
>remain intact for a
> second then crack progressively before disintegrating.
> Did this lady
> have a "Looney Tunes fracture"?
>
>
>
>
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