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 2024/11/10 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