Childhood trauma Flashcards
What are the risk factors for childhood trauma?
Previous fracture
Metabolic bone disease
What are the principles of childhood trauma?
Fractures often simple, incomplete and heal quickly
Remodel well in plane of joint movement
Thick periosteal hinge is good
Fractures involving physes cn result in progressive deformity
What are the types of forearm fracture?
Shaft
Galeazzi
Monteggia
Distal radius
What is a galeazzi fracture?
Impact to distal ulna causes fracture of radius
What is a monteggia fracture?
Impact to proximal radius causes ulnar fracture
What are the types of low energy forearm fracture?
Buckle
Greenstick
What are the types of high energy forearm fracture?
Open
Displaced
Soft tissue injury
How is a suspected broken limb assessed?
History
Deformity
Soft tissue exam- wounds, sensation, motor function, vascular status
Xray
What is the treatment of a fracture of the distal radius?
Buckle= Cast for 3-4 weeks Greenstick= cast 4-6 weeks Complete= Cast +/- pin 6 weeks
What are the complications of a limb fracture?
Compartment syndrome Non union Refracture Posterior interosseus nerve injury Superficial nerve injury, esp radial in radius fracture
What is the differential for knee trauma?
Infection Inflammatory arthropathy Neoplasm Apophysitis Hip injury Foot injury Sickle Haemophilia
What ar the types of bony injury of the knee?
Physeal injury Metaphyseal injury Tibial spine Tibial tubercle Patellar fracture Patellar dislocation Sleeve fracture Osteochrondral lesions
What are hyperextension physeal injuries associated with?
Vascular injury
What are fibular injuries associated with?
Common fibular nerve injuries
What is the treatment of physeal injuries?
Cast
Percutaneous fix
What is the risk with tibial spine injuries?
Overlaps with ACL
In children, ACL rarely snaps
What is the treatment of a tibial spine injury?
Long leg cast
Open reduction and internal fixation
What is the management of a patellar fracture?
Undisplaced- cylinder cast
Displaced- open reduction and internal fixation
What are the risk factors for patellar dislocation?
Laxity of ligaments Poor vastus medialus oblique Q angle Femoral anteversion Tibial external rotation
What is the management of a patellar dislocation?
Reduce Brace for stability but keep mobile Weightbear Physio Surgical
When is surgical treatment required in patellar dislocation?
Recurrent
Repair ligaments
What is often the plane of ankle fracture?
Physis
How are ankle fractures assessed?
History
Deformity
Soft tissues- wounds, sensation, motor function, vascular status
Xray- AP and lateral
What are the types of ankle fracture?
SH 1-4
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