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    13 - Fracture in Children

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    Manow Chawisa
    The document discusses differences in fractures and dislocations between children and adults, including differences in bone structure, healing ability, treatment approaches, and common fracture patterns seen at different ages. Key differences include the presence of growth plates in children, faster healing in children, and more non-operative treatment approaches for children.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    13 - Fracture in Children

    Uploaded by

    Manow Chawisa
    17 views34 pages
    The document discusses differences in fractures and dislocations between children and adults, including differences in bone structure, healing ability, treatment approaches, and common fracture patterns seen at different ages. Key differences include the presence of growth plates in children, faster healing in children, and more non-operative treatment approaches for children.

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    13 - Fracture in children

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    The document discusses differences in fractures and dislocations between children and adults, including differences in bone structure, healing ability, treatment approaches, and common fracture patterns seen at different ages. Key differences include the presence of growth plates in children, faster healing in children, and more non-operative treatment approaches for children.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    17 views34 pages

    13 - Fracture in Children

    Uploaded by

    Manow Chawisa
    The document discusses differences in fractures and dislocations between children and adults, including differences in bone structure, healing ability, treatment approaches, and common fracture patterns seen at different ages. Key differences include the presence of growth plates in children, faster healing in children, and more non-operative treatment approaches for children.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 34

    wasupperextreme

    Orthopedic Department
    Center of Clinical Medicine-Rajavithi Hospital
    & QSNICH, ICMDR
    Purpose

    Common Fracture &dislocation in children


    Fxnowepiphysis
    Epiphyseal plate injury
    Differences of fractures and dislocations in
    child vs adult
    Differences between child vs adult
    elasticityno nudes

    mainin
    on
    epiphysis

    .Easier to occur Unison ji


    non

    : smaller in size aminoform


    bone filmooo
    gun

    :less density of bone


    . Difficult to diagnose
    two i xray
    www.nmnounmain
    di't
    standard
    incast Warn
    wa periosteum un

    Less corporations
    Presence of growth plate
    Presence of secondary
    ossification centers
    difference of x-ray
    findings in different age
    2nd ossification center + Vanvooren risotto
    ,

    - Ñ In Ong

    at least review
    xrayhealing
    now 2months
    calluschiusi

    .Difference in treatment
    :mostly can be treated nonoperatively
    fixationin
    o n ur
    teint d d

    .Faster to heal swanewhealing


    into reductionsiniriasswhy
    heal ininnbloodsupplyovens

    :the older needs more time to heal


    .Greater capacity to
    remodel bone now Mariana
    I

    Arianna

    Binda

    nignonniormivininvonni

    tibial
    o
    plats
    fx mating

    uniton
    iii
    .Less incidence of
    ligamentous injuries ,
    joint dislocations and intra-
    articular fractures
    :less strength of growth
    plate
    .Difference in complications

    Less incidence of
    nonunion in a minionrain
    adult

    fo nonunion
    crow
    delayunion

    Less joint stiffness


    anadultnomaincomplete Iron
    nun
    comminute
    transverse

    .Difference in fracture patterns


    Incomplete fracture
    #plastic deformation
    #greenstick fracture
    bone Damn Dinos Ananta : . bone v. Vineeth
    p bone doing

    #Torus or Buckle
    a. gun

    Fractures dorsal
    quin
    cortex

    Complete fracture
    # Bayonet i complete fracture awww earning
    nowrisusannan torn
    bending

    in
    displace
    reduction
    atry
    iron
    Epiphyseal plate injury
    nWo

    plate = physis
    NDIVV 092

    bone

    longitudinal growth
    charm Wwa
    ,

    the immature bone


    Salter and Harris
    Classification
    I tryreduction

    two tours type


    complete
    phasis tx
    now iroi
    displacenon dis x-ray Inno

    d
    in
    intrarticon
    extender
    a compression

    t
    final diag ÑOMRI

    mostcommon lesscommon
    Treatment

    orcast
    Type I & II-->Closed reduction +/- fixation nosin plate
    growth

    Type III &IV -->Operative Rx


    Type V :Gentle reduction,Closed observation
    ,Surgical correction
    compression
    Supracondylar fracture
    of Humerus
    most common elbow injury (75%) Awvoronin

    Q
    peak incidence 5-8 year of age

    .Extension Type (97%) distalfragment

    2.Flexion Type (3%)


    flexion ant humeral
    an .

    line

    capitulum oefuii Ant


    iondynrAx
    supra

    Gartland Classification

    Type I :non displaced or minimally displaced


    Type II : displace but intact posterior cortex
    Type III : totally displaced
    mygym
    him cap
    antiproton
    cap .
    flexelbowwinor

    Treatment
    Indisplace in
    Type I : long arm slab for 3 wks
    common
    an
    reduction minibar
    closed

    Type II: CR +\-pinning apply long arm slab for 3 wks

    totallyrdisplace
    inn
    Type III : CR+pinning+ long arm slab
    innosern
    :ORIF
    amedial
    ino
    sunulnar
    minivan air
    m
    sires
    amedia
    I1st

    mm
    Complications
    Ian'smoreflexawwwcompressinjury

    Nerve injury
    Vascular injury
    Cubitus varus
    Lateral condyle
    Fracture of Humerus
    the second most common (17%) of elbow injury
    in children
    :common missed diagnostic fracture win sinruins
    onion
    onion
    c enter
    osteotication

    :may further displaced by extensor muscle


    group
    Classification

    subtypes

    invousamm
    z amm
    Treatment
    unsound

    pinata
    osteofication
    pinon
    epiph
    area
    phases

    -2 mm -->Long arm cast 4wks ( FU every 3-5 days)


    -4 mm -->Closed reduction and Percutaneous
    pinning
    >4 mm or rotated fragment-->ORIF
    Forearm Fraacture
    Common fracture Ininnwinninin isartsunion

    Fall on outstretching hand


    Incidence proximal 5 % , shaft 15-25
    %,distal 70-80 %
    Associated elbow injury 13% : be careful
    Treatment film i it above
    1 it Samir

    Most of cases : Long arm cast


    Older child : ORIF with plate & screw ,
    9
    intramedulary pin
    n'lionize yr
    Long Arm Cast in Rx of
    forearm fracture in children
    ORIF Forearm Fracture
    gender
    Rev
    Femural Shaft Fracture
    Axininn
    rosinchildabuse inno

    Common in children 5 bur

    mu shaft
    % fracture at diaphysis
    Fracture in younger child ,Child abuse
    has to be rule out
    A incomplete wirin

    Treatment
    complete

    nounsnow

    Depend on Age and Severity


    Mostly treat by non-operative
    fx femur on
    Pavlik Harness → Iota 0-6 month

    Hip spica cast 6m of

    Flexible IM rod
    ORIF c Plate & Screw
    Younger Children (0-6 Mo)

    flexhip flexknee
    Younger Children
    hip spica cast
    are
    .

    flexureHerm
    narrow

    I
    Novosiuirinin

    honour wanna Eisner


    Older Children

    sin
    holdfr
    No

    innit

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