![]() A posterior fat pad is an abnormal finding. An anterior fat pad is normally visualized at the elbow, but an effusion will cause elevation of the fat pad (sail sign). Small, occult, or intra-articular fractures may not be noted on initial radiography. Oblique views can be used to supplement the basic series if the presence of a fracture remains in doubt. Standard radiography should include posteroanterior and lateral views. Much of the subsequent management is based on the radiologic evaluation of the fracture. Patients with an olecranon fracture are candidates for nonsurgical treatment if the elbow is stable and the extensor mechanism is intact. ![]() Mason type I radial head fractures can be treated with a splint for five to seven days or with a sling as needed for comfort, along with early range-of-motion exercises. Isolated ulnar fractures can usually be managed with a short arm cast or a functional forearm brace. Distal radius fractures with minimal displacement can be treated with a short arm cast. Initial management of forearm fractures should follow the PRICE (protection, rest, ice, compression, and elevation) protocol, with the exception of compression, which should be avoided in the acute setting. In the absence of these findings, many forearm fractures can be managed by a primary care physician. Fractures demonstrating significant displacement, comminution, or intra-articular involvement may also warrant orthopedic consultation. Open fractures, joint dislocation or instability, and evidence of neurovascular injury are indications for emergent referral. Proper initial assessment includes a detailed history of the mechanism of injury, a complete examination of the affected arm, and appropriate radiography. Fractures of the forearm are common injuries in adults.
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