PEDIATRIC FX NON ACCIDENTAL TRAUMA Flashcards
ossification center at bony prominence; under traction
apophysis
key with buckles, and to see displacement, what view is this?
lateral view
occur in porous metaphysis when forces compress along the longitudinal plane
lack of swelling or ecchymosis
cortex buckling or acute sharp angulation of cortex
stable fx; spring for pain relief; in ED, arrange for a f/u
*do not displace
name this fx?
meds fx-buckle
what is this fx?
known as plastic deformation
usually in ulna/fibula; radius also
elastic deformation with stress; if forces subside, no true fx
no hemorrhage, limited swelling
comparison views may be necessary to confirm diagnosis
bow fx
fx on tension side as compression side bends
not associated in kids
what is this fx?
greenstick/complete fx
most common growth plate fx, (85-90%) into the metaphysis, see a chip
Thurston sign
what is this growth plate fx?
type II
typical fx for a toddler who lands from height on lateral aspect of shoulder
greenstick predominate in middle third area
Rx with comfort measures
neonates present with a healing callus following difficult delivery
humeral head fx are rare
what is this fx?
clavicle fx
what is this fx?
common between 4 mos-7 yrs; peak at 15-30 months
girls and left arms more common
annular ligament torn/dislocated
pulling theme
no swell or ecchymosis, kids hold wrist; cry elevates with supination
warn parent about audible click
-hyperpronate the forearm, feel click with your opposite thumb
-shaking hand technique gives slight traction on the arm then fully supinates and flexes the forearm-
nursemaids elbow
fat pad sign is an indication of what fx?
elbow fractures
what is this fractures?
sprains rare, buckles and salter II are most common injuries
carpal fx rare pre-teen
volar wrist splints suffice
include elbow if pain wit supination or pronation
wrist fx
which films best to ID buckles and avulsion fx?
latera/oblique films
which fx can be treated with bed rest, crutches and analgesic
ring fx rare, avulsion fx of iliac spines in sports injuries, hip dislocations rare in children
pelvic fx
small metaphysical chips at ends of long bones indicate non accidental trauma after violent twisting, not associated with child abuse
femur/tibia fractures
patellar dislocations lateral; more in girls; flex hip, extend knee, push medially with thumbs
check for joint air if suspect penetration; consider tapping joint elsewhere
advocate quad exercise in girls with chondromalacia patella
seen in what problems?
knee problems
pain and swelling at distal fibular physis implies growth plate injury
normal 5th metatarsal apophysis is parallel to bones long plane; fx is oblique/perpendicular
os vesalianum is accessory ossicle at the base of 5th metatarsal
beware of 1st metatarsal buckles, pesudoepiphysis seen on large toe
seen in what fx?
ankle/foot fractures
