Chapter 30: Musculoskeletal Function Flashcards
How do pediatric fractures differ from adult fractures?
Children’s bones are more porous, pliable, and less dense, which makes them more prone to fractures. Children’s epiphyseal (growth) plates are vulnerable, which can affect bone growth if injured. Healing is faster due to rapid bone growth.
What is the Salter-Harris Fracture Classification?
A classification system used for fractures involving the growth plate (epiphyseal plate).
Type I – Straight across the growth plate; Type II – Across growth plate and metaphysis; Type III – Through growth plate and epiphysis; Type IV – Through metaphysis, growth plate, and epiphysis; Type V – Crush injury to the growth plate (most serious).
What are the 5 P’s of fracture assessment?
Pain at point of tenderness, Pulse distal to the site, Pallor, Paresthesia (tingling/numbness), Paralysis (inability to move).
What are key components of fracture assessment and nursing care?
Immediate neurovascular checks (color, warmth, movement, sensation, cap refill), Pain management, Immobilization (splint or cast), Educate family on cast care and when to return to the hospital.
What should families be taught about cast care?
Keep the cast dry, clean, and elevated (especially when fresh). Do not insert objects into the cast. Monitor for signs of circulatory impairment (5 P’s). Teach frequent neurovascular checks. Watch for increased pain, swelling, odor, or drainage.
What is scoliosis?
Lateral (S or C-shaped) spinal curvature >10°, may involve rib and spinal rotation.
When do we screen for scoliosis?
Screen during preadolescent growth spurt—typically in school-age children.
What do we look for in scoliosis screening?
Trunk asymmetry, Uneven shoulders/hips, One-sided rib hump, Prominent scapula.
How is scoliosis managed?
Mild (10–20°): Strengthening/stretching; Moderate (20–40°): Bracing; Severe (40–50°+): Spinal fusion surgery.
Nursing considerations for scoliosis?
Body image concerns, Post-op care: Pain control, monitor for hemorrhage, ileus, and immobility complications, Family education on long-term care.
What is SCFE?
The head of the femur slips off the growth plate and displaces posteriorly.
What age group is affected by SCFE?
Typically seen in overweight adolescent males, especially during growth spurts.
Signs and symptoms of SCFE?
Hip, thigh, or knee pain, Limp, Limited internal rotation, Obligatory external rotation of the hip. Diagnosed via AP pelvic x-ray (“ice cream slipping off a cone”).
What is Legg-Calvé-Perthes Disease?
Temporary loss of blood supply to the femoral head → necrosis and eventual repair.
What age group is affected by Legg-Calvé-Perthes Disease?
More common in boys aged 4–8 years.
Signs and symptoms of Legg-Calvé-Perthes Disease?
Hip pain (may radiate to knee), Limp, Leg length discrepancy, Limited internal rotation and abduction.
Treatment and nursing care for Legg-Calvé-Perthes Disease?
Activity restriction, PT, possible bracing or traction. Maintain hip alignment, monitor mobility and growth.
