Children's Fractures - 08/11/18 Flashcards Preview

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Flashcards in Children's Fractures - 08/11/18 Deck (26)
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1
Q

What % of children get injured every year?

A

25%

2
Q

Which gender more commonly gets fractures?

A

Boys

3
Q

Which limb is most common for childrens fractures?

A

Upper limb

4
Q

What are 3 fractures that are specific to children?

A

Greenstick
Torus
Plastic deformation

5
Q

Describe the bony anatomy of childrens bone?

A

Physis = Growth Plate
On the joint side - epiphysis
Shaft - Diaphysis
Metaphysis is extending to diaphysis

6
Q

What is Wollfs law?

A

Bone in a healthy person will adapt to the load under which it is places

7
Q

What is hueter volkman law?

A

Compression forces inhibit growth and tensile forces stimulate growth

8
Q

Is fracture healing better in children or adults?

A

Children

9
Q

What important aspects of the history are important?

A
Mechanism
How high?
How Fast?
Forces involved
Predict injuries and exclude or confirm
10
Q

What are features of non accidental injury?

A

History that does not match the nature of the injury
Vague parental accounts, or account that change
Accusations that child injured themselves intentionally
Delay in seeking help
Child dressed inappropriately for the situation
Any obvious or unsuspected fractures in a child under 2
Injuries in various stages of healing
More injuries than usual
Scattered injuries
Increased intracranial pressure
Suspected intra-abdominal trauma
Any injury that does not fit the description

11
Q

What is important in the LOOK part of the examination?

A

Deformity
Swelling
Bruising
Assymetry

12
Q

What is important in the FEEL part of the examination?

A

For point tenderness that correlates with X-ray

13
Q

What is important in the neurovascular exam?

A
Colour
Capillary refill
Skin temperature
O2 saturations
Pulse
Sensation
Sweating
Skin wrinkling
14
Q

What is the MOVE part of the examination?

A
Often too painful
DNV
OK sign - medial
Hitchikers thumb - radial
Star fish - ulnar 
Initial force on impact
15
Q

What causes a fracture to displace?

A

Muscle action and gravity

Initial force on impact

16
Q

What can cause a wrist drop/

A

Radial nerve impingement

Humeral fracture`

17
Q

What are symptoms of ulnar nerve damage?

A

Loss of function of hands and fingers

18
Q

What is used in the diagnosis of child fracture?

A

X-ray if ossified
Ultrasound
Arthrogram for joint injuries
CT or MRI for detail

19
Q

What are the 3 Rs of fracture management?

A

Reduce
Retain
Rehabilitate

20
Q

What important in the reduce part?

A

Remodelling potential reduced need for accurate reduction at a young age

21
Q

What is gallows traction?

A

Suspending legs off of the bed
3 months to 3 years
<48 hours traction and then spica or inpatient traction 2/52

22
Q

What is important in the Retain part?

A

Broad arm sling support
Collar
Cuff

23
Q

Which fractures definitely need fixed?

A

Displaced Intraarticular fractures
Displaced growth plate injuries
Open Fractures

24
Q

What is the classification for physeal injuries?

A

Salter Harris classification

25
Q

SALTER acronym

A
S- Straight across
A - Above
L - Lower
TH - Through everything
R - cRush
26
Q

What are the indications for external fixation?

A

Contaminated wounds
Acute vascular injury
Burns
Multiple injuries

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