Ortho - Fractures Flashcards
What are epiphyseal growth plates made of?
Hyaline cartilage [
Label
Why are children more likely to have greenstick fractures?
Children have growth plates
More cancellous bone (spongy and highly vascular)
Adults have more cortical bone
Therefore children’s bone are more flexible but less strong, more prone to greenstick fractures
Why do fractures in children heal more quickly?
Good blood supply so able to heal much more quickly with less long term deformity
Why are children more likely to have buckle fractures?
Less strength against compression
What are the different types of paediatric fractures?
What is used to categorise growth plate fractures?
Salter-Harris classification
SALTER
Type 1 - Separated
Type 2 - Above
Type 3 - Below
Type 4 - Through
Type 5 - ERasure or crush
What safeguarding questions should be asked regarding fractures?
Does the story make sense?
Has it happened before?
How are fractures managed?
Mechanical alignment
Closed reduction - manipulation of the joint
Open reduction - via surgery
Stability
Fix bone in place while it heals
- External casts
- K wires
- IM wires
- IM nails
- Screws
- Plates and screws
How is pain managed in children?
Step 1
Paracetamol or ibuprofen
Step 2
Morphine
Morphine generally need admission
Why are codeine and tramadol not used in children?
Unpredictability in metabolism
Effects vary too greatly to make them safe and effective options
Why is aspirin not used in children under 16?
Risk of Reye’s syndrome
Except certain circumstances e.g. Kawasaki disease
