Fractures In Pediatric Skeleton Flashcards
Why is the pediatric bone more susceptible to bending forces?
Because it has a lower modulus of elasticity
Pediatric bone has ___(more/less) cancellous bone.
More
More cancellous bone means:
1) Reduced tensile strength
2) Reduced tendency of fracture propagation
3) Reduced comminuted fractures
Significance of the periosteum in pediatrics?
1) Metabolically active
2) Thick and strong
3) Affects fracture pattern
4) May aid reduction
Infants are more likely to have what kind of fractures?
Diaphyseal
Children are more likely to have what kind of fractures?
Metaphyseal
Adolescents are more likely to have what kind of fractures?
Epiphyseal
Why do pediatric fractures have a rare incidence of delayed and non-union complications?
Better blood supply
Which is stronger in pediatrics: the growth plate or the bone?
Growth plate
Most growth plate injuries occur in which layer? Why?
Hypertrophic zone; Weakest
Which injuries account for 25% of all children’s fractures?
Physeal
Physeal injuries are more common in:
1) Boys
2) Upper limbs
Prognosis of Physeal injuries in children?
Good healing with good remodeling
If the germinal cell layer has been injured, what might be affected?
Growth
Less than 1% of physeal injuries cause __.
Physeal bridging
Small physeal bridges (<10%) management?
Nothing, they lyse spontaneously
Which physeal bridges cause deformity?
Peripheral bridging
Physeal bridging treatment?
Fixation
Which classification is used for fractures in pediatric skeleton?
Salter Harris
Prognostic factors in pediatric fractures?
1) The treatment
2) The severity
3) The patient’s age
4) The physis injured
State the factors affecting the remodeling potential of all pediatric fractures.
1) Years of remaining growth!!
2) Position in the bone
3) Plane of motion
4) Physeal status
5) Growth potential of adjacent physis
Pediatric remodeling is better when it is closer to the:
Physis
Pediatric remodeling is best in which plane?
Sagittal
Which growth potential is better: Distal humerus or proximal humerus?
Promixal humerus
Which growth potential is better: Distal radius or proximal radius?
Distal radius
K-wires are most commonly used for which fractures?
Metaphyseal
What are the common complications in pediatric fractures?
1) Growth disturbance
2) Vascular (Volkmann’s ischemia)
What are the child abuse fracture signs seen on x-ray?
1) Ring fracture from twisting
2) Postero-medial rib fracture
3) Skull fracture
What should you avoid in pediatric fractures?
Multiple reduction attempts
