RT Book, Section
A1 Turner, Christian
A1 Grady, Matthew
A1 Ganley, Theodore
A2 Shah, Samir S.
A2 Zaoutis, Lisa B.
A2 Catallozzi, Marina
A2 Frank, Gary
SR Print(0)
ID 1122463122
T1 Orthopedics
T2 The Philadelphia Guide: Inpatient Pediatrics, 2e
YR 2016
FD 2016
PB McGraw-Hill Education
PP New York, NY
SN 9780071829212
LK accesspediatrics.mhmedical.com/content.aspx?aid=1122463122
RD 2024/04/25
AB Musculoskeletal  complaints  and  injuries  are  some  of  the  most  commonly  encountered  problems  in  pediatrics.  In  addition,  children  have  immature  musculoskeletal  systems  that  pose  particular  challenges  that  are  quite  different  than  those  of  adults.Children  have  open  growth  plates,  or  physes,  located  between  the  epiphysis  and  the  metaphysisFractures  most  commonly  occur  near  the  metaphysis  or  physis  An  open  growth  plate  is  cartilaginous,  and  has  not  yet  calcified,  which  makes  it  the  weakest  part  of  the  immature  bonePediatric  bones  are  less  brittle  than  adults  leading  to  some  distinct  fracture  patternsIn  a  buckle  fracture,  compression  force  leads  to  partial  failure,  but  the  fracture  does  not  traverse  the  entire  boneA  greenstick  fracture  occurs  due  to  tension  or  torsion  force  that  leaves  the  cortex  and  periosteal  sleeve  intact  of  one  side  of  the  boneAngulated  fractures  in  children  have  a  much  greater  potential  to  remodel  back  to  original  shape  than  fractures  in  adults.  Remodeling  potential  is  greatest  in:  younger  patients,  injuries  near  a  growing  physis,  and  those  in  the  plane  of  motion  congruent  to  an  associated  jointOpen  fractures  require  consultation  with  Orthopedic  SurgeryConsider  child  abuse  as  a  factor  in  pediatric  fractures.  Injuries  concerning  for  abuse  include:  Bucket-handle  (metaphyseal  corner)  fractures,  multiple  fractures  of  different  ages,  posterior  rib  or  scapular  fractures,  and  long  bone  fractures  in  children  that  do  not  walk