Pediatric Fractures.docx

**Pediatric Fractures** **Key Differences in Pediatric Bones** - **Skeletal Immaturity**: Pediatric bones are still growing. - **Presence of Growth Plate**: Unique to pediatric bones and crucial for growth and development. - **Impact on Treatment and Complications**: Fractures involvin...

**Pediatric Fractures** **Key Differences in Pediatric Bones** - **Skeletal Immaturity**: Pediatric bones are still growing. - **Presence of Growth Plate**: Unique to pediatric bones and crucial for growth and development. - **Impact on Treatment and Complications**: Fractures involving growth plates can affect treatment plans and lead to specific complications. **Salter Harris Classification** A diagram of different types of bones Description automatically generated - **Salter Harris I**: - Fracture through the growth plate. - **Prognosis**: Generally good, may be occult on imaging. - **Salter Harris II**: - Fracture through the growth plate and metaphysis. - **Prognosis**: Good, most common type. - **Salter Harris III**: - Fracture through the growth plate and epiphysis. - **Prognosis**: Can lead to premature growth plate fusion and osteoarthritis, involving joint space. - **Salter Harris IV**: - Fracture through growth plate, metaphysis, and epiphysis. - **Prognosis**: Similar to Type III, poor due to joint space involvement. - **Salter Harris V**: - Crush injury through the growth plate. - **Prognosis**: Poor, often occult on imaging, can cause vascular injury and premature growth plate fusion. **Radiographic Examples** - **Salter Harris Fracture II**: - **X-Ray**: Fracture of the growth plate extending through the metaphysis. - **Patient**: Skeletally immature. - **Prognosis**: Good, most common type.  - **Salter Harris Fracture III**: - **X-Ray**: Fracture involving growth plate and epiphysis. - **Patient**: Skeletally immature. - **Prognosis**: Poor, can cause premature growth plate fusion and osteoarthritis. An x-ray of a person\'s leg Description automatically generated - **Salter Harris Type I: Slipped Capital Femoral Epiphysis (SCFE)**  - **X-Ray**: Fracture involving proximal femoral growth plate. - **Population**: Most common in African-American boys and obese children. - **Appearance**: Widening of the physis, medial displacement of epiphysis (\"ice cream slipping off the cone\"). - **Prognosis**: Requires close intervention. An x-ray of a hip joint Description automatically generated **Incomplete Fractures**  A screenshot of a computer screen Description automatically generated - **Torus (Buckle) Fracture**: - **Definition**: Partial compression of the cortex. - **Population**: Common in pediatric bones. - **Example**: Buckling of distal radial cortex seen in wrist x-ray.  - **Greenstick Fracture**: - **Definition**: Fracture involving one side of the cortex. - **Population**: Common in pediatric bones. - **Example**: Partial fracture of the distal radius seen in wrist x-ray. A close-up of x-ray of a human bone Description automatically generated **Supracondylar Fractures** - **Definition**: Most common elbow fracture in children. - **Indicators**: Presence of a posterior fat pad sign. - **Diagnosis**: - **Anterior Humeral Line**: Should intersect the middle of the capitellum; misalignment suggests a fracture.  **Summary** - **Salter Harris Classification**: Essential for diagnosing pediatric fractures involving growth plates. - **Incomplete Fractures**: Common in children, including torus (buckle) and greenstick fractures. - **Supracondylar Fractures**: Most common elbow fracture in children, diagnosed by posterior fat pad sign and anterior humeral line misalignment. \_\_\_\_\_\_ Salter Harris II fractures\...? - \...have a good prognosis. Which of the following is TRUE regarding the pediatric Salter-Harris classification of fractures? - Top of Form - There are 5 types of fractures in the Salter-Harris classification. The slipped capital femoral epiphysis is...? - Bottom of Form -...seen most commonly in boys. Which is the most common type of elbow fracture in a child? - Supracondylar