MSK: Part 8 Flashcards
Define fractures
- Soft tissue injury in which there is a break in the continuity of surface of substructure of the bone
Where do high energy injuries take place
Pelvic or femur fracture
What is the bone shaft in children called
Diaphysis
What is the peri-articular part of the bone called (ends of long bones)
Metaphysics
What is physics
Growth plate that has not fused
Blood supply of the epiphysis
Endoosteal and periosteal blood supply
Why is healing of bone better in children than adults
Children have an EXCELLENT PERIOSTEAL BLOOD SUPPLY so their rate of healing is MUCH HIGHER and is thus SIMPLE
More cancellous bone present in children which is softer - simple repair needed
Why are ligament damages in children very rare
They are extremely strong
Why do ligament injuries in children cause fractures
So strong - bone to bone
If they tear, they take the bone with it
Common fracture site in neonates
Humerus and clavicle due to fracture from birth
Common fracture site in infants
Radius
Common fracture site in children
Fibula, radius and femur
Common fracture site in adolescent
Tibia
What is an oblique fracture
Diagonal tear
What is a transverse fracture
Horizontal
What is a linear fracture
Vertical
What is a spiral fracture
Diagonal around the bone perimeter
What is a comminuted fracture
Section between bone is fragmented and separates the bone
What usually causes comminuted fracture
High energy impact
What causes a spiral fracture
Twisting injury
Where is an oblique fracture found
Ankle due to axial load injury
What age group is effected by greenstick fracture
SPECIFIC to children
What is a greenstick fracture
Unicortical fracture in which the bone bends and breaks due to thick periosteum
How easy is it to treat a greenstick fracture
EASILY because bone is not completely broken down
What is the salter-Harris fracture classification
Classification for fractures involving the physics (growth plate) - higher the number the more damage and worse prognosis
What are the most common parts of the bone that get fractures in children
Epiphysis
Metaphysis
Major complication of Salter-Harris fracture classification
GROWTH ARREST
How are fractures managed
- Reduce fracture -> restore length, alignment and rotation -> immobilise (to allow healing) -> rehabilitate
How do most kids fractures heal
Non-operatively due to extremely quick healing as a result of their thick periosteum with excellent blood supply
What deformity will be remodelled if there is more than 2 years growth left in a bone
Angular deformities
What deformity will not be remodelled if there is more than 2 years growth left in a bone
Rotational deformity
How do we tell if a child has angular or rotational deformity
Regular X-rays to ensure no rotational/angular movement
Treatment for paediatric fractures
- Internal operational fixation
2. External fixation
What is Internal operational fixation
- Plate, screws, intramedullary nails or K-wire
Complication of internal operational fixation
If nails or K-wire INVADE the physics (growth plate) then there will be growth arrest
When are external fixations done
Lots of soft tissue swellings and damage so don’t want to open skin to reduce risk of infection and bad healing
Ex-fix or Lizard flame