Peadiatric Trauma

Question 1

what increases the risk of a fracture?

Answer 1

> metabolic bone disease
previous fracture
(age increases risk of physeal injury)

Question 2

what is a greenstick fracture?

Answer 2

this occurs on young soft bone, think of a new branch on a tree if it is snapped one side is bent and still attached

Question 3

describe a type 1 salter harris fracture

Answer 3

transverse fracture through the growth plate

Question 4

what is a tarus/buckle fracture?

Answer 4

incomplete fracture where the bones buckles in on itself

Question 5

describe a type 2 salter harris fracture

Answer 5

transverse fracture through the growth plate and an oblique fracture through the metaphysis

Question 6

what is a type 3 salter harris fracture?

Answer 6

transverse through growth plate and vertical fracture through the epiphysis

Question 7

describe a type 4 salter harris fracture

Answer 7

a vertical fracture through the growth plate, metaphysis and epiphysis

Question 8

describe a type 5 salter harris fracture

Answer 8

a compression fracture or crushing of the growth plate

Question 9

name some principles of fractures in children

Answer 9

> often incomplete and heal quickly due to cellular bone and a metabolically active periosteum
they remodel well in the plane of the joint
thick periosteum hinge is usually helpful
fractures involving the physis can cause overgrowth or arrest resulting in progressive deformity

Question 10

what would you want to assess in a forearm fracture?

Answer 10

> sensation
wounds
vascular status
mechanism of injury

Question 11

what complications can follow a forearm fracture?

Answer 11

> compartment syndrome
> PIN injury
> refracture
> radioulnar synostosis
> superficial radial nerve injury
> radiocapitellar problems

Question 12

how would you manage a knee physeal injury?

Answer 12

> percutaneous fix

> cast immobilisation

Question 13

how would you manage physeal arrest in a knee injury>

Answer 13

> monitor the harn's lines for deformity
> correct osteotomy
> resect bone
> complete epiphysiodesis
> contralateral epiphysiodesis

Question 14

what different stages of tibial spine injury exist?

Answer 14

1: undisplaced
2: hinged
3: displaced

Question 15

what different types of tibial tubercle injuries exist?

Answer 15

1: distal avulsion
2: prox. to tibial physis
3: into joint

Question 16

until what year roughly is the patellar tendon cartilaginous?

Answer 16

4th year

Question 17

what management is used for undisplaced patellar fracture?

Answer 17

sleeve cast

Question 18

what is the management for a displaced patellar fracture?

Answer 18

ORIF surgery

Question 19

what different types of knee osteochondral lesions are there?

Answer 19

1: cartilage is intact
2: flap
3: fragment

Question 20

true or false

the ligaments of the ankle are weaker than the physis of the ankle bone

Answer 20

false

the physis is weaker

Question 21

what imaging would you order in a suspected ankle fracture?

Answer 21

AP and lateral x-rays

Question 22

name 2 overuse injuries

Answer 22

> Osgood-schlatters disease

> severes disease

Question 23

what are some problems with childrens bones in regards to trauma?

Answer 23

> physis can result in slip, overgrowth or arrests

> cartilage is tricky on the imagine

Question 24

what are some pros of childrens bones?

Answer 24

> cartilage means they are resilient
periosteum creates a hinge
bones heal quickly
physis allows for remodelling

Question 25

what are some red flags of non-accidental injuries?

Answer 25

> burns
> multiple fractures
> metaphyseal fractures
> rib fracture
> humeral shaft fracture
> non-ambulant fracture
> bruising pattern