Pediatric Fracture Considerations
- Children’s bones are more porous and heal faster but are prone to epiphyseal injuries (growth plate fractures).
- Risk of non-accidental fractures: Posterior rib fractures, skull fractures, injuries that don’t match the story
Salter-Harris Fracture Classification
Classifies growth plate fractures into five stages based on severity.
5 P’s of Fracture Presentation
- Pain
- Pulse (distal to fracture)
- Pallor
- Paresthesia (distal to fracture sensation)
- Paralysis (movement distal to fracture)
Fracture Assessment & Care
- Neurovascular assessment (capillary refill, color, warmth, movement, sensation).
Treatment:
- Reduction (realigning bone).
- Immobilization (cast, surgery).
Cast Care Teaching
- Elevate extremity.
- No objects inside the cast.
- Check for circulation (cap refill, warmth).
- Keep edges clean & dry
Scoliosis Definition
Sideways curvature of the spine (>10 degrees)
Scoliosis Screening
During preadolescent growth spurt.
Scoliosis - Sign
Uneven shoulders/hips, rib hump, trunk asymmetry
Scoliosis Managment
- Mild (10-20°): Strength/stretch.
- Moderate (20-40°): Brace.
- Severe (>40°): Surgery
Scoliosis Nursing Consideration
Pain management, body image support
Slipped Capital Femora Epiphysis (SCFE) Cause
The femoral head slips off the growth plate
Slipped Capital Femoral Epiphysis (SCFE) - Common in
Teen boys, overweight children
Slipped Capital Femoral Epiphysis (SCFE) - Symptoms
Hip, thigh, or knee pain, limited internal rotation.
Slipped Capital Femoral Epiphysis (SCFE) - Diagnosis
X-ray (looks like “ice cream slipping off a cone”).
Legg-Calve Perthes - Cause
The femoral head slips off the growth plate
Legg-Calvé-Perthes - Common in
Boys, ages 4-8
Legg-Calvé-Perthes - Symptoms
Hip pain, limp, leg length difference
Legg-Calvé-Perthes - Treatment
Activity restriction, PT, possible bracing
Types of Immunity
Natural Passive Immunity
Natural Active Immunity
Artificial Active Immunity
Artificial Passive Immunity
Natural Passive Immunity
Definition: Antibodies are passed from mother to child.
Achieved Through: Placenta during pregnancy and breast milk.
Example: Maternal antibodies protecting newborns.
Duration: Short-term; wears off after a few months
Natural Active Immunity
Definition: Immunity develops after infection.
Achieved Through:
Exposure to a disease, triggering the body to produce its own antibodies.
Example: Child gets chickenpox, recovers, and gains lifelong immunity
Artificial Active Immunity
Definition: Immunity developed after vaccination.
- Achieved Through: A vaccine stimulates the body to produce antibodies.
- Example: MMR vaccine leading to long-term protection
Artificial Passive Immunity
Definition: Pre-formed antibodies are given for immediate protection
- ## Achieved Through: Injecting immune globulin.
- Example: Rabies immune globulin (RIG) given after an animal bite
5 stages of Salter - Harris
o 1 – through growth plate
o 2 – through growth plate and metaphysis (most common)
o 3 – through growth plate and epiphysis
o 4 – through all elements
o 5 – crush injury of growth plate
