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Needed, Dr. Hive Update in 1st post


Night Elf
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Dd tripped and fell yesterday. She hurt her arm. I'm trying to decide if I need to drive her to urgent care which is an hour away. She says she can only move it in certain ways. She can't straighten it, raise it up, or bend it tightly. Does she need an x-ray? Could it be a hairline fracture or something? If it's just sprained, can they do anything for her? She's not in tears. It doesn't hurt much if she just keeps it bent slightly and held against her stomach.

 

Update: I went ahead and took her in because she didn't want to miss school tomorrow. It is a small break at the top of her radius and a buildup of fluid around her elbow. They splinted her arm and we'll follow up with the orthopedist. I took her to urgent care because it's Kaiser's advanced care center which is like a small hospital. The problem now is getting the right referral. The doctor was stressing the importance of making sure they refer her from the correct home medical facility, which sounds like a great place for them to mess up. In the 20 years I've had Kaiser though, I've only ever had one problem with them so hopefully this will work out okay. Thanks for the help!!

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If she's unable to move it I'd be inclined to get an X-ray. I'd consider if it's worse from yesterday or better, and swollen. Do regular pain meds (Tylenol plus Motrin) allow her to move her arm? If so I'd be less inclined to go to urgent care. Sprains sometimes get soft or semihard splints. Have you iced it for swelling? Any loss or change in feeling (pins/needles)?

 

Eta just because of the distance to urgent care I'd consider ER instead if one is close. The cost difference may be worth the drive. :(

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She did ice it last night. It's not swollen. She's moving it in circles but if she tries to go too far, it hurts but she can't describe the pain. She just says it hurts. But she's not wincing when she does it. She can make a fist but she can't squeeze it hard. DH was just checking her out and and he feels it's her elbow. She can lift her arm over her head as long as she keeps her arm slightly bent.

 

We have Kaiser and they would probably want us to drive to the urgent care which is a mini-hospital, unless it's a true emergency.

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Unless she can't sleep, or it looks obviously broken, I'd give her the maximum amount of ibuprofen and call an orthopedist in the morning. I've never had good results with injuries at an urgent care, and some small fractures actually take a few days to show on an X-ray.

 

This has been my experience as well. In fact, urgent care missed the fracture. Radiology found it, but ortho did new x-rays anyway. A friend had a wrist break that didn't show up for several days. If there is any numbness or similar issues indicating nerve or blood flow changes, I would take her in immediately. Otherwise, I would probably wait and go directly to ortho.

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I think it can wait until tomorrow.  When my son broke him arm on a Saturday we went to urgent care and got x-rays.  They said it was broken and basically wrapped an ace bandage with a splint around it and told us to take him to an orthopedist on Monday morning.  At the orthopedist, they x-rayed it again and casted it.

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This has been my experience as well. In fact, urgent care missed the fracture. Radiology found it, but ortho did new x-rays anyway. A friend had a wrist break that didn't show up for several days. If there is any numbness or similar issues indicating nerve or blood flow changes, I would take her in immediately. Otherwise, I would probably wait and go directly to ortho.

This. Urgent care missed dh's fracture too. Dsil's brother (an er dr) insisted he go to an er when he fractured his knuckle.

 

Of course even the children's hospital missed 1ds's fractured vertebra.

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