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Fig. 1

Pucker sign. The sharp edge of the proximal fragment penetrates into the subcutaneous tissue (arrow).

Fig. 2

Undisplaced fracture of the distal humerus shows the fat pad sign (arrow) around the posterior aspect of the elbow. It is an important sign when the invisible fracture is suspicious.

Fig. 3

(A) A completely displaced fracture (Gartland III) of a 7-year-old boy. (B) After closed reduction, percutaneous pinning was performed with 3 pins. (C) A satisfactory alignment was achieved at 6 months postoperatively.

Fig. 4

After failure of closed reduction for a displaced supracondyar fracture (A), an anterior approach was used to reduce it (B, C), and to fix it percutaneously (D, E). At 8 months, an excellent functional outcome was achieved with a satisfactory alignment (F, G).

Fig. 5

An anterior-posterior elbow view of a 14-month-old boy shows that the proximal radius and ulna are displaced to the medial side (arrows). However, the central line of the radius (dot line) passes the center of the capitellum, which means not the lateral condyle fracture. As the lateral view of the elbow shows a small distal fragment, it is a fracture-separation of distal humeral physis.

Fig. 6

A completely displaced fracture of the lateral condyle (A) was reduced with closed manipulation (B) and fixed with K-wires. (C) A satisfactory reduction was gained (D), and the union was achieved at 6 months (E).

Fig. 7

(A) A Bado type IMonteggia fracture. (B) After internal fixation with a plate, the radial head was anatomically reduced.

Fig. 8

A completely displaced (Delbet type I) femur neck in a 12-year-old girl (A). Open reduction and internal fixation was performed (B), but avascular necrosis developed at 4 months (arrow) (C). Vascular fibular graft was performed (D) as a salvage procedure. At 9 years, the joint was preserved with a satisfactory function (E).

Fig. 9

A displaced femoral neck fracture (A) (11-year-old girl) underwent multiple screw fixation after open reduction (B, C). A satisfactory reduction was achieved (D), followed by the uneventful union without avascular necrosis (E).

Fig. 10

A type II femoral neck fracture (A) treated with screw fixation (B). Although the union was achieved, a partial type of avascular necrosis occurred at 6 months (C).

Fig. 11

(A) A posterior hip dislocation of a 12-year-old boy. (B) The well-reduced hip after closed reduction.

Fig. 12

An anterior hip dislocation (A) was reduced closely (B). However, avascular necrosis occurred at 6 months (C).

Fig. 13

A fracture at the physis of the distal femur in a 12-year-old boy (A) was reduced and fixed with K-wires (B). At 6 months postoperatively, a valgus deformity (C) developed with the physeal arrest on the magnetic resonance imaging (arrow) (D).

Figure & Data

REFERENCES

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