Musculoskeletal: what’s different in children? Brother steps on hand: pain and swelling for 1 week

Excerpt

This 3-year-old male was fooling around and playing with his brother. His brother accidently stepped on his left hand but they kept on playing. However, swelling and bruising shortly occurred and he did not want to use his hand completely. His parents did not think it was serious enough to bring him to the Emergency Room (ER) and so he kept going to school and playing. Swelling improved but bruising was still present and he did have pain with flexing the hand. Because of the lingering symptoms, the patient was brought to our ER, whereupon he was noted to be in good health but did have some swelling of his left hand. He could flex it but he did not really want to do it, and when asked where his pain was most pronounced he sort of rubbed his fingers around the palm and dorsal aspect of the lower hand. Because of this, radiographs of the left hand and right hand for comparison were obtained (Fig. 1). Do you see a fracture?

…