oldkidontheblock
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D
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| inkspot
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b?
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| rock
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i would have chosen B
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| kamyabi
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Yeah , the major concern is stunted/uneven growth but honestly speaking the way question is put
"main concern at this time? "
the first thought that came to my mind was "severe pain" .
If this q was on my test I would have chosen D but I agree that answer should be B .
Edited by kamyabi on 04/04/07 - 12:04 PM
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| Feyza
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if I were the patient I would like my doc to stop the pain first so I guess it should be D ...it smells like a typical show right hit left type distracting Q to me 
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| obgyne2b
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When we learned about bone fractures in school, this was a big point, how bone healing and growth are affected depending on the location of the fracture. I think "severe pain" and "hematoma" are distractors. I would choose B.
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| paganini
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D
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| quansar
Forum Newbie
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yeah, as the pt you want the physician to stop the pain as the primary concern. but as the doc, your concern will be beyond the obvious. pain is easy to deal. read the q stem one more time, it is obvious BBBB that is the answer
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| flajar
Forum Junior
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i had this same exact question, and i do not remember the stem saying at this precised moment. I chose answer b where the plates would cause stunted growth. the kids obviously in pain since hes in the hospital, is that not redundant??
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| determine08
Forum Newbie
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my 2 cents : i think ans is D , as in the ques , they r asking What is the physician's main concern at this time? so I think right at this time pain will be pain concern .
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| obgyne2b
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If this were a step 2 question testing clinical stuff, then I would choose D. Step 1 being a test of basic sciences, I would choose B. I think pain is relative to the patient. Children are usually scared of hospitals whether in pain or not, and will cry regardless. I think the patient's main concern is pain. Or in this case, the parent of the patient. The physician should be more concerned with the clinical situation at hand, and that is the extent of the injury and the best outcome possible.
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| new_n_lost
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Aha Guys Wht abt A. infection - Osteomyelitis. We will have a Very Sick little dude who will go into remission if the hematoma is not cleared adequately stunted growth can be managed at a later time but if gets an infection there wheter u like it not there will be stunting
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| mytime
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Now everyone has managed to get here there everywhere..........so? TEEEE 
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| jole
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i would go for A-infection
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| junoon
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When a patient comes to ER in such a condition as broken arm obviously the first concern is pain b/c the patient is crying with extreme pain so the first concern of the Doc is to treat the pain & than think about the uneven growth & infection problems.
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| rock
Forum Elite
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seems like this has blossomed into a real good discussion ...good 4 all of us here
honestly i was also confused between B and D. i am now only trying to make a few points, i dont know how rational they will be in cilnical practice in US, so if they are not i will be only happy if someone corrects it.
now, is pain really that much of a concern ? yes, agreed the patient is in pain(he's got a godamm fracture), so give him the pain medication. shouldn't the doctor be worrying more about how to manage the fracture at the growth plate so that it does not end up with patient having one arm shorter than the other arm which can be far debilitating for the patient later in life.
like i said this is what i thought and not necessarily the right thought...but just trying to make a point so that i can alter my thinking process if i am not right.
and about the infection...well i am not sure about this one but the stem does not say that it is a compound frature or an open fracture so i did not think about this one.
i hope we can find the right answer to this one.
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| new_n_lost
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My 2 cents
It wont be pain cos he is bound to have pain & besides an 8 yr old will be crying a lot due to pain n fear of punishment from Parents. He is Coming to ER cos he is in severe Pain Secondly I choose A initially based on 1 point Hematoma. then i searched for the answer as to y there has to be a logic behind the Question and the Asnwers provided. Most Children of his age have Elbow Fractures n If he is having a Hematoma over there then he is at serious risk for Ischemic injury therefore his chances of getting an Infection r to be thought later. but Right Now his Initial Condition Warrants immidiate care cos Vascular insufficiency or swelling may lead to Volkmann ischemic contracture of the forearm, markedly limiting function of the extremity.
SO in My view its the Answer Shud be B
Edited by new_n_lost on 04/04/07 - 06:39 PM
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| mytime
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OH so u agree!
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| new_n_lost
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Yes i do agree now n i was wrong the First time didnt know that therecan be a Ischemic Injury contraction in the dude.
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FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| ShweHope99.9998
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Before scroll down, I was thinking, does any one go for "A " .
So , final ans. "A " , or which?
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| me007
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http://orthoinfo.aaos.org/fact/thr_report.cfm?thr...
looks like B.
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| epica
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Ans is Beeeee
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| mytime
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Oh my like the sheep  we all flock! I wonder y no one thot EEEEEEEEEEE......... HEHEHEHEHE!
I wonder where we can find TEEEEEEEEEEEEEEEEEEEEE.
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| epica
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Mytime i like your jokes, I feel after exam I will be like "e-e e -e"
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