5: Children's fractures Flashcards
What injury do children commonly sustain?
Fractures
Most children’s fractures tend to involve the (upper / lower) limb.
upper limb
Why do children have unique fracture patterns?
Different composition of bone
stretchier, thicker periosteum
What is a Greenstick fracture?
Cortical fracture on the outside, compression stretch on the inside
What is a buckle / Torus fracture?
Bulging of bone due to plastic deformation
In general, children’s bones tend to ___ rather than break.
bend
What are commonly mistaken for fractures on X-rays of kiddos bones?
Epiphyseal growth plates
What is Wolff’s law?
Calcium is laid down in areas of stress
i.e bone which isn’t stressed won’t be strong
Children have better ___ potential than adults.
This means that poorly ___ fractures often still repair themselves.
remodelling
poorly reduced
must ask all about mechanism of injury, how high, how fast!
What is an NAI?
Non-accidental injury
What aspects of a history suggest towards an NAI?
History doesn’t match nature/severity of injury
Vague/changing parental account
“He/she injured himself”
Delay in seeking help
NAI or brittle bone disease (for example?) history
elbow joint
anteriorly - brachial artery, median nerve
posteriorly - ulnar nerve (funny bone)
diaphyseal fractures have to be immobilised above and below to prevent rotation
metaphyseal - only nearest joint needs to be immobilised
