Ortho trauma assessment paeds

Question 1

steps in assessment of ortho trauma in children 2

Answer 1

pain control

clinical examination and correlation of clnincal signs with radiogrpahs

Question 2

examples of pain contrl in ortho trauma patients in kids 2

Answer 2

intransal diamorphine

femoral nerve block for femoral fractures

Question 3

facts about fracture patterns in children

Answer 3

near or involving growth plate are important in childern

Question 4

classification of grwoth plate infjureis

Answer 4

salter- harris classificatoin

Question 5

when should growth plate fractures be referred to ortho

Answer 5

type 3 and 4 of the salter-harris classification

-as they are intra-articular

Question 6

why are intra-articular fractures particulary serious 2

Answer 6

high risk of growth distrubances

likely to need surgery

Question 7

open fracture manageemnt 3

Answer 7

cleaned

given ABx

dead and de-vitalised tissue needs removed and the fracture must be stabilised

Question 8

differneces between fractures in adults and children 4

Answer 8

fracture patterns
-buckle fractures, plastic deformatoin and greenstick fractures
-theses arent possible in adults becuase of mechanial property of immature bone in different
-childs bone is less brittle

time to healing
-femoral fractures heal in age + 1 in weeks
-physeal fractures 2-3 weeks
-adult fractures heal much more slowly

remodelling is better in children

treatment is differnet
-ridgid internal fixation are more common inchildren compared to adults with plaster casts and percutaneous fixation with fine wires

Question 9

commonest fractures in children 2

Answer 9

commonest fracture are distal forearm and wrist injuries

Question 10

particulary dangerous fracture and why

Answer 10

supracondylar humeral fractures
-assocated with injruy to major nerves of the upper limb and vascular injruy is well recognised

Question 11

types of child abuse

Answer 11

phsycial
emotional
sexual
neglect
fabrication of illness

Question 12

responisblities of assessing a child with non-accidental injury 7

Answer 12

THINK THE UNTHINKABLE
-get into the habit every time you see the child

take and accurately document the history and any variations
-so it would stand up in a court of law

examine child fully
-fully undress child to underwear
-accureatley document findings in all systems

informa senior, social work

concern about sexual abuse requires referral to child protection team urgently
-DO NOT DO A GENITAL EXAM

ensure child in place of saftey before you leabe

consider other children in the family