Paeds Trauma

Question 1

Periosteum in kids bones

Answer 1

Thicker, rich source of Obs

Stays intact

Question 2

When are kids fractures treated as adult fractures?

Answer 2

Age 12-14

Question 3

Fractures around physis

Answer 3

Potential to disturb growth = shortened limb, angular deformity

Question 4

Salter Harris 1

Answer 4

SLIP
Physeal separation
Best prognosis

Question 5

Salter Harris 2

Answer 5

ABOVE
Small metaphyseal fragment attached to physis (distal radius)
Commonest
Angulation and deformity = manipulation

Question 6

Salter Harris 3

Answer 6

LOWER
Below physis in epiphysis
Intra-articular
Greater chance of growth arrest
Reduce and stabilise

Question 7

Salter Harris 4

Answer 7

THROUGH EVERYTHING
Intra-articular = greater change of growth arrest
Reduce and stabilise

Question 8

Salter Harris 5

Answer 8

RAMMED
Crushed compression injury
Growth arrest

Question 9

Features of NAI

Answer 9

Multiple fractures/bruises of varying ages
Inconsistent/changing history of events
History not consistent with injury/age
Atypical injuries, rib fractures

Question 10

Buckle fracture

Answer 10

Distal radius
Stable, 3-4 weeks splintage
Expanded cortex

Question 11

Greenstick fracture

Answer 11

Distal radius
One side fractured, other side bent
Angulated
Manipulation, casting

Question 12

Monteggia and Galeazzi fractures

Answer 12

GRIMUS
Galeazzi: radial inferior fracture, ulnar head dislocation
Monteggia: ulna superior fracture, radial head dislocation
Reduction and rigid fixation

Question 13

Weak point in growing limb

Answer 13

Distal humerus

Heavy FOOSH = supracondylar fracture

Question 14

Treatment of femoral shaft fracture in kids

Answer 14

Less than 2 - NAI, Gallows traction, hip spica cast
2-6 - Thomas splint, hip spica cast
6-12 - flexible intramedullary nail
12 - intramedullary nail

Question 15

Toddler’s fracture

Answer 15

Undisplaced spiral fracture of tibia

Cast