Chapter -45 Childrens Fractures And Joint Injuries

Question 1

List three ways in which fractures in children differ from fractures in adults and briefly explain each

Answer 1

1. The bone is softer + pliable and therefore they have green stick and buckle fractures
2. There are beneficial growth factors due to growth potential – > faster healing, remodeling due to differential physeal growth, there is a growth spurt following a fracture due to increased blood supply to the physis(Remodeling occurs if angulation is close to the joint and in the Line of joint movement. Ie fracture at the wrist remodels in all planes and at the elbow only in the Sagittal plane)
3. Injury at the joint results in growth plate injury - instead of ligamentous tears or dislocations

Question 2

What is the mechanism of greenstick and buckle fractures?

Answer 2

Cortex undergoes plastic deformation

Question 3

What is the relevance of bayonet opposition?

Answer 3

Certain femur fractures can be managed conservatively and they unite with overlap and shortening. The growth spurt is valuable in this type of fracture because up to 2cm of shortening An be caught up after 2 years.

Question 4

What is the weak area around a child’s joint called? ( where fractures occur)

Answer 4

The growth plate or physis

Question 5

In which layer of the growth plate does the fracture occur?

Answer 5

Hypertrophic layer

Question 6

Which classification is used for growth plate injuries?

Answer 6

Salter and Harris classification

Question 7

For salter and Harris type 1 and 2 injuries

1. Are they intra or extra articular?

Answer 7

Extra articular