General Medical Level A 4 year and 6 month old male sustained a fall onto an outstretched left arm. He presented to the emergency room with forearm deformity and acute pain. This history is very suspicious combined with the fracture pattern this is not likely caused by accidental trauma.
Further investigation is indicated.
The x-ray of the arm shows an isolated fracture of the ulna and radius. Question 21C This injury can easily be reduced and held in a cast and should heal with no residual effects. 9 months later she again presented to the emergency room with a history of a fall on the out stretched hand. She now has a minimal dorsally angulated radial fracture distal to the previous fracture. This indicated that the girl probably has osteogenesis imperfecta and should have a further work up.