Paediatric trauma Flashcards

1
Q

Why are children’s fractures generally simple, incomplete, and quick to heal?

A

Metabolically active periosteum
Cellular bone
Plastic

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2
Q

Why do children’s fractures remodel well in plane of joint movement?

A

Appositional periosteal growth/resorption

Differential physeal growth

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3
Q

What are the main types of forearm fractures?

A

Shaft fractures
Galeazzi
Monteggia
Distal radial fractures

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4
Q

What happens in low energy fractures?

A

Buckling

Greenstick

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5
Q

What happens in high energy fractures?

A

Open, displaced, soft tissue injury

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6
Q

What is greenstick?

A

Failure of one cortex in compression, other cortex in extension

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7
Q

How is buckle fracture managed?

A

Cast for 3-4 weeks

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8
Q

How is greenstick fracture managed?

A

Cast for 4-6 weeks

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9
Q

How is complete fracture managed?

A

Cast 6 weeks

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10
Q

What are differentials for knee trauma?

A
Infection
Inflammatory arthropathy
Neoplasm
Apophysitis
Hip
Foot
Sickle cell
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11
Q

What bony injuries could lead to knee pain?

A
Physeal/metaphyseal
Tibial spine
Tibial tubercle
Patellar fracture
Sleeve fracture
Patellar dislocation
Referred pain from hip
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12
Q

How is physeal injury treated?

A

Cast and immobilise
Percutaneous fix
ORIF articular displacement
Range of movement early

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13
Q

What are the 3 stages of tibial spine injury by Meyers and McKeever’s criteria?

A

I - Undisplaced
II - Hinged
III - Displaced

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14
Q

What are the 3 stages of tibial tubercle injury by Ogden’s criteria?

A

I - Distal avulsion
II - To proximal tibial physis - not into joint
III - To proximal tibial physis - into joint

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15
Q

What are risk factors for patellar dislocation?

A
Laxity
Poor VMO
Q angle
Femoral anteversion
Tibial external rotation
Patella alta
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16
Q

How is ankle fracture assessed?

A

History - mechanism
Deformity
Soft tissues
Radiographs

17
Q

What are ottawa rules for ankle fracture?

A

Series of Xray films is required only if there is any pain in maleolar or mid-foot zone and any of the following:
Pain at posterior edge of tip or lateral malleolus
Pain at base of fifth metatarsal
Pain at naviculum
Inability to bear weight immediately or in emergency dept.

18
Q

What is a transitional fracture?

A

Fracture while growth plate is closing - usually age 13-14

19
Q

What are warnings of non-accidental injury?

A
Incongruent history
Bruising pattern
Burns
Multiple fractures, multiple stages of healing
Metaphyseal 
Ribs
Non-ambulant
20
Q

What is mugger relating to monteggia and galeazzi?

A

Monteggia is ulnar

Galeazzi is radial

21
Q

What is monteggia?

A

Ulnar fracture with radial head dislocation - force comes from medial side

22
Q

What is galeazzi?

A

Radial fracture with dislocation of distal radioulnar joint