fracture management

Question 1

general management of fractures

Answer 1

analgesia
assess neurovascular compromise
immobilise the limb
assess skin integrity for open fractures
complete early childhood injury proforma for children under 2 years

Question 2

open fracture management

Answer 2

urgent treatment is needed to prevent infection
IV antibiotics should be given without delay
Tetanus booster should be considered
open wounds should be washed out in the ED with sterile saline
cover the wound with povidone iodine soaked gauze
apply backslab
call ortho

Question 3

non accidental injury red flags

Answer 3

delay in seeking medical advice
inadequate supervision
repeated injuries
injury unexplained or unwitnessed
injury not consistent with history
injury non consistent with developmental stage
evidence of neglect
unusual behaviour
concerns regarding carer
any fracture in a child not yet walking
multiple fractures
femoral shaft fracture <2 years
spiral fractures of the humerus
corner or bucket handle fractures in infants

Question 4

salter harris 1

Answer 4

S - seperation within the physis
no damage to the metaphysis or epiphysiis

Question 5

salter harris 2

Answer 5

A - along the growth plate with a component of the metaphysis attached to the displaced epiphysis fragment

Question 6

salter harris 3

Answer 6

L - beLow the epiphysis

Question 7

salter harris 4

Answer 7

T - through the growth plate
from the articular surface, through the growth plate, into the metaphysis

Question 8

salter harris 5

Answer 8

ER - erasure of the growth plate
very rare
initial x-rays may appear normal