Paediatric Trauma

Question 1

What are salter Harris, green stick and torus fractures?

Answer 1

Salter Harris fractures are fractures involving the growth plate

Greenstick fractures are when fractures occur in young soft bone where the bone bends and breaks

Torus (buckle) fractures are incomplete fractures of the shaft of the long bone characterised by bulging of the cortex

Question 2

What are the different types of growth plate fractures according to the salter Harris classification?

Answer 2

1: fracture through the physeal plate
2: fracture through metaphysis and physis
3: fracture through epiphysis and physis
4: fracture through metaphysis, plate and epiphysis
5: direct compression

Question 3

What are the common sites of injury and what makes you suspicious of non accidental injury?

Answer 3

Incongruent history
Bruising pattern
Burns
Multiple fractures 
Multiple stages of healing

Sites: metaphyseal, humeral shaft, ribs, non ambulant

Question 4

How are childhood fractures managed?

Answer 4

Assess: history, deformity and soft tissues
Radiography
Treatment: closed or open reduction, fixation, immobilisation

Question 5

What are the complications of childhood fractures?

Answer 5

Compartment syndrome
Nonunion
Refracture
PIN injury
Radioulnar synostosis 
Superficial nerve injury