Paeds Fractures Flashcards
Why are children’s bones more susceptible to not fully breaking?
Thick periosteum tends to remain intact and hence no complete break
Why do children’s fractures tend to heal quicker than adult fractures?
Thicker periosteum rich in osteoblasts
+
Greater potential to remodel
The majority of children’s fractures are treated by manipulation followed by casting.
What is the anomaly to this in that they require ORIF? Why is it different?
Monteggia and Galeazzi dislocation fractures - high risk of re-dislocation if just manipulation and casting used
What area of the bone to be fractured is associated with the worst prognosis?
Physis
What system is used to classify physis fractures?
As the classification progresses does prognosis improve or not?
Salter-Harris classification
Prognosis gets poorer as scale progresses + more likely to result in growth arrest
Go to Onenote and name each of the Salter-Harris classifications correctlyq
Go to Onenote
What type of Salter-Harris fracture is most common?
Describe what it looks like?
Where is a common site for them to be found?
Salter-Harris II
Through the metaphysis but excluding the epiphysis
Distal radius
Name three types of fracture in infants that would raise suspicion of NAI?
- Rib fracture
- Metaphyseal fracture
- Femoral shaft fracture in child under 2
How are buckle and greensticks fractures of the distal radius managed differently?
Buckle - stable fractures which require split for 3-4 weeks
Greenstick - usually stable but can angulate and may require manipulation and casting
What fracture can occur from a fall onto a flexed knee in a child?
- Femoral shaft fracture
- Patellar fracture
How will a femoral fracture affect a child later in life?
In a femoral fracture has occurred esp. in a young child
Shortening of affected leg can be expected
What must be remembered when addressing femoral shaft fractures in a child?
Femur is a common site for tumour formation - could be a pathological fracture
At what age would a femoral shaft fracture no longer be treated with hip spica casting/splint and traction and instead with IM nail?
6 yo
Describe the “toddler’s fracture”
How does it occur?
Undisplaced spiral fracture of the tibial shaft
Twisting injury when tripping/stumbling/falling
