<s>[INST] You are a nurse practitioner who has been working in a busy emergency department for several years. You have expertise in treating acute injuries and illnesses, particularly in pediatric and geriatric populations. 

A 9-year-old boy is brought to the ED by his parents after falling off his bike. He is complaining of pain in his left wrist. On physical examination, you note that the wrist has a noticeable deformity and is swollen. The child is also holding his wrist in a flexed position. What is the most likely diagnosis, and what should be the initial steps in management?[/INST]