Paediatric Trauma

Question 1

Risk factors for trauma in paediatrics

Answer 1

Boys, age, increased risk of physeal injury, previous fracture and metabolic bone disease

Question 2

Children’s fractures are often

Answer 2

Simple, incomplete and they heal quickly (due to metabolic active periosteum)

Remodel well in plane of joint movement (due to differential physeal growth and appositional periosteal growth)

A thick periosteal hinge

Question 3

Fractures involving the physes can result in

Answer 3

Progressive deformity of the elbow, and growth arrest in the knee and ankle.

Question 4

Forearm Injuries in Children

Answer 4

Shaft fractures.

Question 5

Galaezzi Fracture

Answer 5

The Galeazzi fracture is a fracture of the distal third of the radius with dislocation of the distal radioulnar joint.

Question 6

Moteggia Fracture

Answer 6

The Monteggia fracture is a fracture of the proximal third of the ulna with dislocation of the proximal head of the radius

Question 7

What fractures of the forearm are most common

Answer 7

distal radial fracture

Question 8

Treatment of Forearm fractures in children

Answer 8

Closed treatment (application of a cast)

Question 9

Principles of closed management

Answer 9

• Analgesia
• Theatre set-up
• Reduce – disimpact, bend force over apex
• Verify
• Well moulded above the elbow
• Check radiographs week 1,2,4
• Change loose casts
• Remove when a callus is evident
• Restrict activity for three to four months

Question 10

Complications of forearm fractures

Answer 10

• Compartment syndrome
• Non-union
• Refracture
• Synostosis
• PIN injury
• Superficial radial nerve injury

Question 11

Buckle Fracture of the distal radius

Answer 11

when the bony cortex is compressed and bulges, without extension of the fracture into the cortex

Question 12

Greenstick fracture of the distal radius

Answer 12

greenstick fracture. incomplete fracture resulting from failure along tension (convex) side. typically plastic deformation occurs along compression side

Question 13

Bayonet Fracture of the distal radius

Answer 13

broken end of the radius is bent backwards.

Question 14

Differential Diagnosis for knee pain and trauma

Answer 14

• Infection
• Inflammatory arthropathy
• Neoplasm
• Apophysitis
• Hip problem
• Sickle
• Haemophilia

Question 15

Indications of physeal injury of the knee

Answer 15

• Hyperextension – vascular injyry

* Varus – CPN injury

Question 16

Treatment of knee injury

Answer 16

• Cast immobilize
• Percutaneous fix
• ORIF articular displacement
• ROM early <6/52