Fractures Flashcards
(32 cards)
What is the significance of the metaphysis in pediatric bones?
Connects to the physis (growth plate), which is an area of weakness in children’s bones
How do ligaments and tendons compare to bones in children?
In children, ligaments and tendons are stronger than bones.
How does the periosteum in children’s bones affect fracture types?
The thick periosteum leads to incomplete fractures like greenstick or torus fractures, and bones tend to bend or bow rather than fully break
What are the types of fractures specific to pediatric bones?
- Greenstick fracture
- Torus fracture
- Plastic deformation
What is a greenstick fracture?
Incomplete fracture where one side breaks, and the other side bends.
What is a Torus fracture
Buckling or creasing of the bone
What is Plastic deformation?
A bone bends and stays bent without an obvious fracture
Why is the growth plate prone to injury in children?
The growth plate (physis) is the weakest part of developing bones and is vulnerable to fractures, which can cause growth deformities
What classification is used for growth plate fractures?
Salter-Harris classification - graded from I to V
What fractures are suspicious for NAI?
Femoral fractures in non-walking children and rib fractures
What is the common classification for supracondylar fractures?
Gartland classification
Type I of Gartland classification
Non-displaced
Type 2 of Gartland classification
Displaced with an intact posterior cortex
Type 3 of Gartland classification
Displaced with posterior cortex disrupted
Type 4 of Gartland classification
Fully displaced
Why are children more suitable for conservative fracture treatment?
Children’s bones have greater remodeling potential and heal rapidly, so less invasive methods like plaster casts and traction are often sufficient
What are the most common types of elbow fractures in children?
Supracondylar fractures
What is a toddler’s fracture, and how does it present?
It is a spiral fracture of the tibia, typically presenting with a child refusing to bear weight.
Initial X-rays may appear normal, but further imaging is required to confirm the diagnosis
Why is non-accidental injury (NAI) important in pediatric fractures?
It indicates potential child abuse
What is an open fracture?
A fracture where the bone breaches the skin and contacts the outside environment
What is the most common type of infection in open fractures?
Polymicrobial
A 54 year old woman is brought into the emergency department having fallen from a horse. The patient appears to have an isolated injury to her right leg, with no history of head injury or loss of consciousness. On initial assessment, the patient is alert and orientated with a c-spine collar and blocks in place, cardiovascular and respiratory examination is unremarkable. The abdomen is soft and non-tender, a pelvic binder is in place. On full exposure, there is a displaced open fracture of the right tibia and fibula, which is contaminated with soil, there is minimal bleeding. The right dorsalis pedis and posterior pulses are absent and the right foot is pale with reduced sensation. No other injuries are found. Observations show a heart rate of 108, blood pressure of 122/63, respiratory rate of 16, oxygen saturations of 98% on room air, and temperature of 36.4 celsius. IV access is available.
What is the single most important initial management consideration?
Reduction of the right lower leg fractures
A 7-year-old boy is brought to the emergency department by his mother after falling down, whilst playing at the playground. He fell on an outstretched hand and is now crying of pain in his right forearm. He stopped playing immediately after the fall and refused to use his right hand.
On examination, his right forearm is swollen and bruised. There is some tenderness on palpation of the middle of the forearm. An x-ray is requested and it shows an angulated fracture in the mid-diaphysis of the right radius. The fracture is incomplete as it goes through the cortex on the convex side of a bone that has been bent while the opposite cortex (concave surface) remains intact.
What type of fracture does this describe?
Greenstick fracture
What is the correct order of fracture healing?
Inflammation - soft callus - hard callus - remodelling
