The Child with a Musculoskeletal Condition

Pediatric Skeletal System

• Pediatric bones are more flexible and prone to bending than adult bones: this is due to the presence of more cartilage and less calcified bone in children.
• Bone healing is faster in children: because of a more robust blood supple and a faster rate of cell division.
• Musculoskeletal assessment should include both mechanical and reflex evaluation: this provides a comprehensive understanding of the child's musculoskeletal status and any potential underlying issues.
• Skeletal growth can be altered by several factors: including nutritional deficiencies, hormonal imbalances, genetic conditions, chronic diseases, and certain medications.
• A common variation in newborn's musculoskeletal system is "toe-in": this refers to the inward pointing of the feet.

Pediatric Skeletal Growth

• Skeletal growth occurs most rapidly during infancy and adolescence: this is due to hormonal surges and increased metabolic activity.
• Multiple fractures at various stages of healing may indicate child abuse: a thorough medical history and physical examination are crucial to assess the cause of the fractures.

Pediatric Gait Development

• By age 6, children typically walk with a mature gait pattern: characterized by a steady pace and a consistent stride length.
• Toe walking after age 3 may indicate a neurological or musculoskeletal condition: such as cerebral palsy, muscular dystrophy, or tight calf muscles.
• Flat feet in children are common due to underdeveloped ligaments: this usually resolves as ligaments strengthen with growth and development.

Pediatric Fracture Management

• Prolonged bed rest is often avoided for fractures in children: this is to minimize complications like muscle atrophy, blood clots, and loss of bone density.
• A greenstick fracture involves a partial break: one side of the bone is broken while the other side is bent.
• A sprain is an injury to a ligament: this can cause pain, swelling, bruising, and difficulty moving the affected joint.

Pediatric Traction

• Bryant's traction is used to treat hip fractures in children: it involves pulling the legs upward to keep the hip joint in a neutral position.

Nursing Care for Children in Traction

• Russell's traction involves a sling under the knee with weights attached to a footplate: it is used for fractures of the femur and lower leg.
• Maintaining skin integrity is crucial when caring for children in traction: this includes regular skin inspections, cleaning, and padding.
• Proper application and maintenance of traction systems are vital: this ensures the traction is effective and prevents complications.

Cast Care

• Cast care includes maintaining cleanliness and dryness: this helps prevent skin infections and irritation.
• Monitor for signs of compartment syndrome: like pain, swelling, and numbness.
• Avoid getting the cast wet: to prevent water damage and potential complications.

Juvenile Idiopathic Arthritis (JIA)

• Oligoarticular JIA affects four or fewer joints: often the knees, ankles, and elbows.
• Systemic arthritis is a type of JIA that may cause fever, rash, and inflammation of the internal organs: this form is often associated with a more serious course of illness.
• Initial treatment for JIA includes reducing inflammation and pain: this often involves anti-inflammatory medications and physical therapy.

Scoliosis

• Structural scoliosis is caused by changes in the shape of the vertebrae: this can lead to a curve in the spine that may require corrective treatment.
• Scoliosis curves less than 10 degrees typically do not require treatment: monitoring for progression is essential.
• A Boston brace is often used for scoliosis curvatures between 20 and 40 degrees: it is designed to help straighten the spine and prevent further curvature.

Nursing Care for Adolescents with Scoliosis

• Prioritizing pain management is crucial for adolescents post spinal fusion surgery: this may involve medications, ice therapy, and physical therapy.

Sports Injuries

• Encouraging adequate warm-up and cool-down routines is a recommended approach to prevent sports injuries: this helps prepare the body for exercise and prevent muscle strain.

Pediatric Musculoskeletal Conditions

• Intense pain not relieved by analgesics may indicate a serious underlying condition: such as a fracture, infection, or nerve injury.
• Staphylococcus aureus infection is the most common cause of osteomyelitis in children under 1 year: this bacterial infection can affect the bone and surrounding tissues.
• Duchenne's Muscular Dystrophy is characterized by progressive muscle weakness and degeneration: this condition predominantly affects boys and often leads to wheelchair dependence.

Slipped Femoral Capital Epiphysis

• The primary treatment for Slipped Femoral Capital Epiphysis (SFCE) involves surgical fixation of the femoral head: this helps stabilize the joint and prevent further complications.

Ewing's Sarcoma

• Ewing's Sarcoma is a type of bone cancer that commonly affects the long bones: it's more common in children and adolescents.

Avascular Necrosis

• Avascular necrosis can occur in Legg-Calve-Perthes disease: a condition that affects the hip joint and can lead to disruption of blood supply to the femoral head.

Osteomyelitis

• Bone biopsy is a diagnostic test for osteomyelitis: this allows for identification of the causative organism and appropriate treatment.

Osteosarcoma

• Chemotherapy is a common treatment component for patients with osteosarcoma: this is often used in conjunction with surgery and radiation therapy.

Muscular Dystrophy

• Duchenne's Muscular Dystrophy is characterized by the absence of dystrophin: a protein that helps maintain muscle cell structure and function.

Osteosarcoma

• A rapidly growing tumor that causes pain and swelling may be a sign of osteosarcoma: this type of bone cancer warrants prompt medical evaluation and treatment.