Pediatric orthopedic emergencies

Nathan W. Mick, Amy E. Valasek

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Key facts • Pediatric bones are more flexible than adults, leading to unique fracture patterns such as: • Buckle fractures • Greenstick fractures • Plastic deformation • Because of the high metabolic turnover for pediatric bones, closed reduction and casting is the treatment of choice for most pediatric fractures • Transient synovitis is an inflammation of the hip joint that typically follows a viral upper respiratory infection (URI) and is characterized by hip pain and a limp • Transient synovitis is typically self-limited and treated with non-steroidal anti-inflammatory medication (NSAIDs), though excluding a bacterial infection is critical to avoid significant morbidity • Slipped capital femoral epiphysis (SCFE) occurs in obese pre-pubescent children. Pain may be indolent in cases of chronic SCFE, though acute worsening of pain is seen after relatively minor trauma in some cases • SCFE presents bilaterally in a significant proportion of cases, even if only one side is symptomatic Unique features of pediatric fractures General principles • Bones in children remodel at a more rapid rate than adults, making closed reduction a viable treatment modality for many fractures that would require operative repair in adults • Bones in children are more flexible, leading to unique fracture patterns such as buckle and greenstick fractures that are not seen in adults • Injury to growth plates can result in significant morbidity Buckle fractures • Buckle or torus fractures typically occur at the metaphyseal diaphyseal junction and result from a “crumpling” of the more porous metaphysis (see Figure 7.1) • Typical locations for buckle fractures include the distal radius, distal tibia, distal fibula and distal femur

Original languageEnglish (US)
Title of host publicationOrthopedic Emergencies
Subtitle of host publicationExpert Management for the Emergency Physician
PublisherCambridge University Press
Pages165-177
Number of pages13
Volume9781107696617
ISBN (Electronic)9781139199001
ISBN (Print)9781107696617
DOIs
StatePublished - Jan 1 2013

ASJC Scopus subject areas

  • Medicine(all)

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