17.1 Children fractures

Question 1

ligaments in kids?

Answer 1

stronger than growth plate, likely to fracture rather than sprain/strain

Question 2

consequence of young bones being more porous?

Answer 2

• tolerates deformation

- fails in compression and tension (buckle/torus #s)

Question 3

which fractures are better at remodelling?

Answer 3

ones closer to the growth plate

Question 4

which fractures tend to overgrow?

Answer 4

usu. femur fractures

Question 5

nonunion in kids? where?

Answer 5

not as common

• usu. displaced intra-articular fractures: synovial fluid inhibits callus formation
• lateral humeral condyle #s

Question 6

what is pulled elbow?

Answer 6

disclocation of radial head from annular ligament

Question 7

ix of fractures?

Answer 7

x-rays: 1 AP, one lateral

• joint above, joint below
• maybe opposite side for comparison
• CT scan PRN

Question 8

monteggia fracture/dislocation is?

Answer 8

ulnar fracture

radial dislocation

Question 9

Rx of displaced fractures?

Answer 9

reduction

• analgesia
• immobility
• sling/collar/cuff
• clinic
• admission

Question 10

when to suspect non-accidental fractures?

Answer 10

• under 3s
• ribs fractures
• corner #s
• bucket handle #s
• caused by twisting

Question 11

open fracture mx?

Answer 11

• digital photo
• remove large contaminants
• sterile dressing
• IV antis
• immobilise
• x-ray
• sx within 6/12

Question 12

which bones common #s in birth injuries?

Answer 12

humerus
clavicle
femur

Question 13

supracondylar humeral fractures when? complications?

Answer 13

3-10ya

• minimal to severe displacement
• 15% risk of nerve palsy
• brachial artery tentrapment

Question 14

3 types of incomplete fractures:

Answer 14

buckle/torus
plastic deformation (ulna usu.)
Greenstick (loss of cortext continuity)