non union

my diagnosis is n/u as evidence by--
1. abnormal mobility in all or 1 plane.
2. transmitted movement absent.
3. shortening
4. palpable gap

differance b/w supracondylar fracture and elbow dislocation

1. in sc# 3 point relationship is unaltered.
2. arm length decrease in sc# and forearm length decrease in elbow dislocation.
in chronic cases, in elbow dislocation triceps shows cord sign.
and olecranon is prominent.
there will be thickening and irregularity along both lateral and medium column.

investigation

1. x rays. 2. blood investigaton ESR, CRP 3. SINOGRAM-- to llocalise sequestrum
4. m/m-- 1. put methylene blue 1 day before to follow sinus tract.
5. sequestromy if involucrum has formed.if you think that after sequestromy bone will become unstable than wait till more involucrum forms.
6. ring sequestrum seen at amputed stumps.
7.TB-- Very little periosteal reaction. feathery sequestrum

Osteomyellitis

patient is usually a child with following points.
1.thickening and irregularity of bone.
2. scar, sinuses present.
3. h/o previous surgery.
4. wasting
X ray -- 1. sequestrum-- dead piece of bone lying in infected nidus.
2. periosteal reaction, cortical thickening.
3.changes in medullary canal
4. proximal joint involved/not involve.