Suspicious Fracture in a Toddler

Clare Cardo McKegney, APRN, CPNP

Disclosures

J Pediatr Health Care. 2008;22(3):196-198. 

In This Article

Physical Examination

C.R. appears well and in no acute distress. His weight is 12.7 kg (50th percentile), and his height is 83 cm (50th percentile). Vital signs reveal a temperature of 36.2°C, heart rate of 94 beats per minute, blood pressure of 88/56 mmHg, and respirations of 16 breaths per minute. Examination of the head, ears, eyes, nose, and throat show him to be normocephalic with full range of motion, without bruising; his sclerae are clear and his pupils are equal, round, and reactive to light with normal accommodation and with ocular movements intact. Upon examination of his ears, there was no battle sign, and his tympanic membranes are intact with normal landmarks. C.R.'s nose is free of discharge, his oral mucous membranes are moist, and his dentition and speech are normal. A chest examination reveals clear and equal breath sounds. Heart sounds are normal with regular rhythm and without murmur or gallop. His abdomen is noted to be nontender, with normal bowel sounds. He has normal male genitalia and is circumcised with testes palpable bilaterally. C.R.'s skin is intact and warm, with normal turgor and without bruising. His clavicles appear normal with no deformity. His lower extremities appear to have normal color, sensation, skin turgor, and range of motion. His left arm is normal upon examination; however, he holds his right arm in a guarded position. A moderate amount of swelling is noted to the mid lateral aspect of the upper right arm, with extreme tenderness anterior and posterior. His radial pulse is easily palpable, and no visible deformity or bruising is noted.

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