Forearm injury in a young boy

A 9 year old boy presented to the emergency department after a fall onto his outstretched left hand while playing. He reported pain, swelling, deformity, and limited mobility in his left forearm. The patient had no history of other relevant medical conditions. On physical examination, no skin injury was detected. The patient’s left forearm was noticeably swollen and deformed, but there was no obvious swelling and tenderness in the left elbow joint; further examination was limited owing to pain. No symptoms of neurovascular damage were observed. A plain radiograph was obtained (fig 1).