Fractures In Pediatric Skeleton

Question 1

Why is the pediatric bone more susceptible to bending forces?

Answer 1

Because it has a lower modulus of elasticity

Question 2

Pediatric bone has ___(more/less) cancellous bone.

Answer 2

More

Question 3

More cancellous bone means:

Answer 3

1) Reduced tensile strength
2) Reduced tendency of fracture propagation
3) Reduced comminuted fractures

Question 4

Significance of the periosteum in pediatrics?

Answer 4

1) Metabolically active
2) Thick and strong
3) Affects fracture pattern
4) May aid reduction

Question 5

Infants are more likely to have what kind of fractures?

Answer 5

Diaphyseal

Question 6

Children are more likely to have what kind of fractures?

Answer 6

Metaphyseal

Question 7

Adolescents are more likely to have what kind of fractures?

Answer 7

Epiphyseal

Question 8

Why do pediatric fractures have a rare incidence of delayed and non-union complications?

Answer 8

Better blood supply

Question 9

Which is stronger in pediatrics: the growth plate or the bone?

Answer 9

Growth plate

Question 10

Most growth plate injuries occur in which layer? Why?

Answer 10

Hypertrophic zone; Weakest

Question 11

Which injuries account for 25% of all children’s fractures?

Answer 11

Physeal

Question 12

Physeal injuries are more common in:

Answer 12

1) Boys
2) Upper limbs

Question 13

Prognosis of Physeal injuries in children?

Answer 13

Good healing with good remodeling

Question 14

If the germinal cell layer has been injured, what might be affected?

Answer 14

Growth

Question 15

Less than 1% of physeal injuries cause __.

Answer 15

Physeal bridging

Question 16

Small physeal bridges (<10%) management?

Answer 16

Nothing, they lyse spontaneously

Question 17

Which physeal bridges cause deformity?

Answer 17

Peripheral bridging

Question 18

Physeal bridging treatment?

Answer 18

Fixation

Question 19

Which classification is used for fractures in pediatric skeleton?

Answer 19

Salter Harris

Question 20

Prognostic factors in pediatric fractures?

Answer 20

1) The treatment
2) The severity
3) The patient’s age
4) The physis injured

Question 21

State the factors affecting the remodeling potential of all pediatric fractures.

Answer 21

1) Years of remaining growth!!
2) Position in the bone
3) Plane of motion
4) Physeal status
5) Growth potential of adjacent physis

Question 22

Pediatric remodeling is better when it is closer to the:

Answer 22

Physis

Question 23

Pediatric remodeling is best in which plane?

Answer 23

Sagittal

Question 24

Which growth potential is better: Distal humerus or proximal humerus?

Answer 24

Promixal humerus

Question 25

Which growth potential is better: Distal radius or proximal radius?

Answer 25

Distal radius

Question 26

K-wires are most commonly used for which fractures?

Answer 26

Metaphyseal

Question 27

What are the common complications in pediatric fractures?

Answer 27

1) Growth disturbance
2) Vascular (Volkmann’s ischemia)

Question 28

What are the child abuse fracture signs seen on x-ray?

Answer 28

1) Ring fracture from twisting
2) Postero-medial rib fracture
3) Skull fracture

Question 29

What should you avoid in pediatric fractures?

Answer 29

Multiple reduction attempts