Paediatric trauma Flashcards
What are some risk factors for paediatric fractures?
Boys Age Previous fracture Metabolic bone disease Season
Why do children’s bone fractures heal easier?
Metabolically active periosteum
Cellular bone
Good blood supply
Often low velocity trauma
How do the easily healing bones of children affect treatment?
Fixation is not usually required
Do not over immobilise
Do not over treat
What are some considerations in soft tissue damage from fractures?
Whole limb Wounds Sensation Motor function Vascular status
When might we supplement a cast with fixation?
Severe swelling likely Need to re-inspect wound (e.g. open fractures) Multiple injuries Segmental limb injuries Fracture very unstable Approaching skeletal maturity
What is a risk with physeal fractures?
Growth arrest
Progressive deformity
Is the physis stronger or weaker than ligaments?
Weaker
What does the Salter-Harris classification do?
Helps predict injuries which may affect growth
When does the growth plate close?
13-14
Boys slightly later than girls usually
What is a Tillaux fracture?
Fracture of the anterolateral tibial epiphysis
Fragment is avulsed due to the strong anterior tibiofibular ligament in an external rotation injury of the foot in relation to the leg
What are some benefits of flexible nailing?
Allow early ROM
Wires out when healed
Minimal disruption
What is an NAI?
Non-accidental injury
What are some red flags for an NAI?
Inconsistent history
Delay in presentation
Fracture pattern does not fit mechanism
Bruising – pattern and different ages
Burns
Multiple fractures, multiple stages of healing
Metaphysis, humeral shaft and ribs often affected
What are some factors often associated with the presentation of osteomyelitis?
Insidious onset
Mainly around knee
Staphylococcus
What is an mnemonic device used to remember salter-harris classifications for physeal fractures?
SALTER
Type I - V
