paediatric trauma

Question 1

pead fracture risk factors

Answer 1

boy
age
previous fracture
metabolic bone disease

Question 2

why do child fractures heal quickly

Answer 2

metabolically active periosteum
good blood supply
cellular bone
usually low velocity trauma

Question 3

application of fact child fractures heal quickly

Answer 3

fixation not usually needed
do not over immbolise
do not over treat

Question 4

types of fractures in kids

Answer 4

complete
greenstick
buckle (torus)
plastic defromity

Question 5

greenstick #

Answer 5

bone snapped on side that force was applied to but not on other side

Question 6

buckle fracture

Answer 6

longitudinal compression
cortex compressed

stable - won’t move under normal physiological load
simple splintage for short time

Question 7

plastic deformity

Answer 7

rare, most commonly forearm
arm bends, does not go back to normal
small sequential cracks on bone

Question 8

Mx options child fractures

Answer 8

conservative (~90%): brace ,splint, traction, cast

operative: external fixation, internal fixation

Question 9

supplement cast with fixation when

Answer 9

segmental limb injuries
severe swelling likely 
need to reinspect wound - open #
approaching skeletal maturity 
very unstable fracture
multiple injuries

Question 10

physeal fracture

Answer 10

fracture involving epiphyseal growth plate

Question 11

physeal fracture classification

Answer 11

salter harris

helps predict injuries that may affect growth

Question 12

physeal fracture: SH-1 and SH-2

Answer 12

good chance heal with no growth disturbance

Question 13

physeal fracture: SH-3, SH-4

Answer 13

much greater chance growth disturbance

Question 14

physeal fracure: SH-5

Answer 14

compression of growth plate

Question 15

apophyses

Answer 15

where tendon inserts to bone

Question 16

avulsion ACL grading

Answer 16

I undisplaced
II hinged
III displaced

Question 17

transitional fractures

Answer 17

when growth plate closing (~13yrs)
typically ankle
central>medial>lateral>fusion

Question 18

tillaux fracture

Answer 18

ligament connective tibia to fibula tears off bit of bone of growth plate when twisting force

Question 19

open reduction internal fixation (ORIF)

Answer 19

adolescents
comminuted fractures
forearm fractures
injuries involving joint surface

Question 20

warning signs to NAI

Answer 20

inconsistent history
multiple # at different stages healing 
rib fracture
burns 
bruising 
fracture pattern doesn't fit mechanism 
delay presentation 
metaphyseal #, humeral shaft #