Fractures Flashcards
Why are children’s bones more flexible than adult’s bones?
Children have more cancellous bone, which is the spongy
What does children’s bones being more flexible make them more prone to?
Children’s bones are more prone to breaking
How is the healing process in children compared to adults?
Bones in children have very good blood supply and are able to heal much more quickly with less long term deformity compared with adults.
How do children’s bones break differently to adults?
Bones in children are more likely to break cleanly in two compared with adults.
Which fracture are children more prone to?
Greenstick fractures
Buckle fracture
What is a greenstick fracture?
Where only one side of the bone breaks whilst the other side of the bone stays intact.
How is greenstick fracture described?
Unicortical break in the cortex
How long can a greenstick fracture take to heal?
8 weeks
What is the mechanism of injury of a buckle fracture?
Axial loading causing one cortex to buckle without affecting the other cortex.
What does the incomplete cortical disruption with a buckle fracture lead to?
Periosteal haematoma
How long does a buckle fracture take to heal?
4 weeks
What can fractures in the growth plate cause?
Issues with growth in that bone
What are growth plate fractures classified using?
Salter-Harris classification
What does the higher the salter-harris grade indicate?
The higher the grade, the more likely the fracture is to disturb growth
What is the SALTER pneumonic?
- Type 1: Straight across
- Type 2: Above
- Type 3: BeLow
- Type 4: Through
- Type 5: CRush (erasure of the growth plate)
What is type 1 on Salter-Harris classification?
Fracture through the physis only
straight across
What is type 2 on Salter-Harris classification?
Fracture through the physis and metaphysis
Above
What is type 3 on Salter-Harris classification?
Fracture through the physis and epiphyisis to include the joint
(below)
What is type 4 on Salter-Harris classification?
Fracture involving the physis, metaphysis and epiphysis
Through
What is type 5 on Salter-Harris classification?
Crush injury involving the physis
ERasure of the growth plate
What is the first principle in the management of paediatric fractures?
To achieve mechanical alignment of the fracture
What can be used to achieve mechanical alignment of the fracture?
- Closed reduction via manipulation of the joint
* Open reduction via surgery
What is the second principle in the management of paediatric fractures?
Provide relative stability for a period of time, to allow healing
What are possible ways that the bone can be fixed in place?
- External casts
- K wires
- Intramedullary wires
- Intramedullary nails
- Screws
- Plate and screws
What is the ladder of pain management in children?
- Step 1: Paracetamol or ibuprofen
* Step 2: Morphine
Buckle fracture
Compression fracture
Break caused by sudden pressure on bone (fall)
Pressure buckles bone without snapping it
Greenstick fracture
Bone bends and cracks rather than complete break
