Paediatric Trauma (Including NAI) Flashcards
Risk factors for paediatric trauma
Boys
Age (increased physeal injury with age)
Previous fracture
Metabolic bone disease
Childrens fracture principles
- often simple, incomplete and heal quickly (do not over mobilise/treat)
- remodel well in a plane of joint movement
- a thick periosteal hinge is good, bones will be fixed by the periosteam and then align and heal
Progressive deformities resulting from fractures involving physes
Deformity - elbow particularity
Growth - knee, ankle
Overgrowth femur
What is scope?
Shaft fracture
Most usual place for scope
Forearm
Complications of scope
compartment syndrome - volkmanns 5% non union 5% refracture radioulnar synostosis PIN injury Superficial radial nerve injury DRUJ/Radio-capitellar problems
Distal radius buckle and torus fracture features
Both failure of 1 cortex in compression
Management cast 3-4 weeks
Knee trauma differential diagnosis
Infection Inflammatory arthropathy Neoplasm Apopysitis Hip Foot Sickle, haemophilia 'anterior knee pain'
Bayonet, offended fracture of distal radius features
completely
management - cast +/- KW for 6 weeks
Greenstick fracture of distal radius features
failure of one cortex in compression, the other cortex in extension
management cast 4-6 weeks
Treatment of knee physeal injury
cast immobilise
Percutanoeus fix
ORIF articular displacement
ROM early under 6 weeks
Treatment of platellar fracture
Undisplaced - cylinder cast
Displaced - ORIF
Pros and cons of physis
pros - remodelling
cons - slip, arrest, overgrowth
Pros and cons of bone
pros - simple fracture, quick heal
cons - plastic deformity
pros and cons of periosteam
pros - hinge
cons - block red’n
