Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

musculoskeletal system 3 > Paediatric Trauma > Flashcards

Paediatric Trauma Flashcards

1
Q

Describe risk factors for fractures in children?

A
  • Boys 60% Girls 40%
  • Age
  • Previous fracture
  • Metabolic bone disease
  • Season
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the principles of childrens fractures?

A
  • heal quickly
  • remodel well in plane of joint movement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Why do childrens fractures heal quickly?

A
  • metabolically active periosteum
  • cellular bone
  • good blood supply
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How does the principle that childrens fractures heal quickly impact treatment?

A
  • fixation not usually required
  • do not over immobilise
  • do not over treat
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What treatment is usually used for childrens fractures?

A

Most fractures need simple treatment

conservative treatment

  • cast
  • braces
  • splints
  • traction

operative treatment

  • external fixation: monolateral or circular
  • internal fixation: IM nail (rigid or elastic), plate fixation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

When should the cast be supplemented with fixation?

A
  • severe swelling likely
  • need to re-inspect wound (such as open fractures)
  • multiple injuries
  • segmental limb injuries
  • unstable fracture
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the 4 types of fracture in children?

A
  • complete fracture
  • greenstick fracture
  • buckle (torus)
  • plastic deformity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

In what plane does remodelling occur in children?

A

most evident in plane of joint movement:

  • appositional periosteal growth/resorption
  • differential physeal growth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

In physeal fractures what does the physis act as?

A

Physis acts as plane of fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are possible complications of physeal fractures?

A
  • growth arrest risk due to closeness to growth plate
  • physis weaker than ligaments
  • can result in progressive deformity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is used to predict injuries that may affect growth?

A

Salter-Harris classification tells you where fracture is and not how much it is displaced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Describe Salter-Harris classification?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What does SH classification stand for?

A

Saltire harris classification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which SH grade is most common?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What SH class has most risk of growth disturbances?

A

Most risk of growth disturbance is in III and IV:

  • Or if in femur, even if SH I injury
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the apophysis?

A

Apophysis is where tendon inserts into bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How does apophysis injury differ in children compared to adults?

A

ligament can be stronger than bone, so injury can cause avulsion of ligament, such as:

  • tibial spine and ACL
  • tibial tubercle and patella tendon (usually requires operative fixation)
18
Q

What are 2 locations where ligament is often stronger than bone?

A
  • tibial spine and ACL
  • tibial tubercle and patella tendon (usually requires operative fixation)
19
Q

What are the different grades of avultion of ACL?

A
  • I Undisplaced
  • II Hinged
  • III Displaced
20
Q

Describe the treatment for avulsion of ACL?

A
  • I/II long leg cast
  • II/III ORIF
21
Q

What are transitional fractures?

A

Occur in children who have almost stopped growing:

  • Growth plate closing, age 13-14 years
  • Standard sequence of growth plate closing
    • Central > medial > lateral
22
Q

What is the standard sequence of growth plate closing?

A
  • Central > medial > lateral
23
Q

Where does transitional fracture usually occur?

A

Usually occurs above ankle, such as Tilliax fracture which occurs due to the lateral side of growth plate closing last:

  • In adult ligament would tear
  • But in child, ligament stronger than bone so bone pulled off growth plate where the plate hasn’t fused
24
Q

What are possible complications of Tilliax fracture?

A
  • Growth arrest
    • Can be asymmetrical growth arrest
    • Affecting gait – walk on outer side of foot
25
Q

Describe the management of Tilliax fracture?

A

Surgical correction

  • external fixator – rarely required
  • ORIF (open reduction/internal fixation)
  • flexible nailing
26
Q

What does ORIF stand for?

A

Open reduction/internal fixation

27
Q

What are indications for ORIF in transitional fracture?

A
  • adolescents
  • comminuted fractures
  • injuries involving joint surface
  • forearm fractures (Monteggia and Galeazi – these both describe fractures of forearm bones)
28
Q

What does NAI stand for?

A

Non-accidental injury

29
Q

Describe the epidemiology of NAI?

(% recurrence, % fatality)

A
  • 50% recurrence
  • 10% fatality
30
Q

What are warning signs for NAI?

A
  • Inconsistent history
  • Delay in presentation
  • Fracture pattern does not fit mechanism
  • Bruising
    • Abnormal pattern or places
    • Or not explained by what child is doing
  • Burns
  • Multiple fractures with multiple stages of healing
31
Q

What is done if warning signs for NAI are seen?

A
  • Skeletal survey
    • X-ray of whole skeleton
  • If we see many fractures at different stages usually means NAI if metabolic bone diseases been excluded
32
Q

What are common NAI fracture locations?

A
  • Metaphyseal fractures
  • Humeral shaft fractures
  • Rib fractures
    • Requires large degree of force
33
Q

What is osteomyelitis?

A

Infection of the bone

34
Q

What are the 2 groups of osteomyelitis?

A
  • Acute osteomyelitis
  • Chronic osteomyelitis
35
Q

Describe the aetiology of acute osteomyelitis?

A
  • Mostly staphylococcus
36
Q

Describe the presentation of acute osteomyelitis?

A
  • Insidious onset
    • Fever
    • Unable to weight bear
    • Pain
  • Mainly around knee
37
Q

What investigations are done for acute osteomyelitis?

A
  • Blood culture
  • X-ray
38
Q

Describe the management of acute osteomyelitis?

A
  • Prolonged high dose antibiotics
  • Aim to prevent acute becoming chronic
  • Rarely requires surgery
39
Q

Describe complications of acute osteomyelitis?

A
  • Can threaten limb and life
40
Q

Describe the prognosis of acute osteomy

  • Cured if caught early and treated
  • Can progress to chronic

elitis?

A
  • Cured if caught early and treated
  • Can progress to chronic

musculoskeletal system 3 (46 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions