Cortex - paediatric trauma 2 (fractures) Flashcards
What is the treatment of a buckle fracture ?
Splintage for 3-4 weeks
What is the treatment of greenstick fractures ?
May be angulated and may require manipulation and casting if there is significant deformity,
What are the main fractures of the forearm we need to know about in kids ?
Monteggia and galeazzi fracture dislocations and fractures of both bones of the forearm
In terms of treatment of fractures for kids what is unsual monteggia and galaezzi fracture dislocations treatment ?
Require ORIF with plates or screws
What is the treatment of fractures of both bones of the forearm in kids ?
- If instability in only one plane then can be manipulated and treated in a cast
- If unstable and flexible - intramedullary nail are usually used
What are suprachondylar fractures of the elbow ?
A supracondylar fracture occurs through the thin part of the distal humerus above the level of the growth plate.
What are the 2 different types of suprachondylar fractures of the elbow and how are they differentiated from each other ?
Flexion and an Extension type
- In the Extension type - the distal fragment is posteriorly
- In the flexion type - the distal fragment is displaced anteriorly
What are the 2 main different mechanism in which Supracondylar fractures of the elbow occur ?
- Extension type fractures are more common and occur due to a heavy fall onto the outstretched hand
- Less common flexion type injury occur with a fall onto the point of the flexed elbow
With serverly displaced suprachondylar fractures of the elbow what muscle may become trapped in the fracture site ?
Brachialis muscle
What sign can extension type suprachondylar fractures cause ?
Due to displacement of the dital fragment posteriorly it can stretch the brachial artery and median nerve - this results in patient being unable to make the “OK” sign due to loss of FPL and FDP to the index
What is the treatment of suprachondylar fractures of the elbow ?
- Undispalced - treated with a splint
- Angulated, rotated or displaced - require closed reduction and pinning with wires
How do femoral shaft fractures occur in children ?
Due to a fall onto a flexed knee or by indirect bending or rotational forces
What is the most common cause of femoral shaft fractures in kids < 2yrs old ?
NAI
Treatment of femoral shaft fractures depends on the age of the child - what is the treatment for different ages of child ?
- For <2yrs old - Gallows traction and early hip spica cast
- For 2-6 yrs old - Thomas splint or a hip spica cast
- For >6yrs old - intramedullary nails
What is the most common type of tibial shaft fracture in toddlers ?
Undisplaced spiral fracture - known as ‘‘todlers fracture’’
