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Case 98: Pale hand

An 8 year old boy fell and sustained a humeral fracture. The orthopaedic registrar has reduced and fixed the fracture in theatre. The hand is now noted to be cold, pulseless and pale.

1. What does the xray show?

2. What associated injury may be responsible for the hand changes?

3. How would you manage this problem?

4. If untreated what is the likely outcome?