ABSTRACT
Dual-energy computed tomography affords emergency radiologists with important tools to aid in the detection and discrimination of commonly encountered ED pathologies. In doing so, it can increase the speed of diagnosis and diagnostic certainty while sparing patients potentially unnecessary downsteam workups and radiation exposure. This article demonstrates these clinical benefits through a case-based approach.
Subject(s)
Radiology , Tomography, X-Ray Computed , Humans , Tomography, X-Ray Computed/methodsABSTRACT
Flexion-type supracondylar humerus fractures remain an uncommon variant of the common extension-type injury. They are often thought to be more difficult injuries, more probable to require open reduction, and have neurovascular complications. We reviewed the 10-year history of flexion-type supracondylar elbow fractures treated at 1 institution and compared these cases with those of an extension-type cohort collected during a similar period. The patients in the flexion-type group (mean age, 7.5 years) were significantly older than those in the extension-type group (mean age, 5.8 years). The fractures in flexion-type group were also more probable to require open reduction (31%) than those in the extension-type group (10%). There was no difference in the incidence of preoperative nerve symptoms; however, the flexion-type group had a significantly increased incidence rate of ulnar nerve symptoms (19% vs 3% in the extension-type group) and need for ulnar nerve decompression. The flexion-type variant should be recognized preoperatively, and the potential pitfalls involved with the treatment of these injuries appreciated.
