Fractures in children

  FRACTURES IN CHILDREN

ANATOMY
 There is a difference between adults and children bones and that is why fractures in children are different from fractures of adults.


  1. Growing skeleton: Skeletal bones are growing in children,at the end of long bones and usually at the end of short bones there is a cartilaginous growth plate and this gives rise to different epiphyseal injuries.
  2. Springy bones: Bones are more resilient and springy, this characeristics is responsible for ''greenstick fracture''.
  3. Loose periosteum: Periosteum is loosely attatched to the diaphysis in children's bones.
  4. Site of fracture:  Common fractures in children are- Forearm bones fracture, supracondylar fracture of humerus, fracture of lateral condyle of the humerus, epiphyseal injuries, spiral fracture of the tibial shaft.
  5. Healing of fractures: Healing of fractures are much faster in children than adults.
  6. Remodelling:  Remodelling potential is very high in children. Remodelling depends on age of child, site of fracture and degree and type of angulation.


TYPES OF FRACTURES

  1. Birth fractures
  2. Pathological fractures
  3. Fracture of shaft of long bones in older children
  4. Epiphyseal injuries


Birth fracture: Fracture which occured due to a difficult delivery are the commonest type of fractures seen at birth.Common fracture are Fracture of shaft of humerus, shaft of femur, clavicle fracture etc.

Epiphyseal injuries: An injury in the growth plate may result in deformities due to irregular growth, and shortening because of premature epiphyseal fusion.

Shaft fracture in older children: Displacement is less in fracture in older children. Perfect end to end alignment is not mandatory, fractures unite faster in children, and fractures in children can be treated by conservative methods.

Pathological fractures: These are uncommon in children, but there are some diseases which are particularly common in children and result in pathological fractures like fractures through cysts, infected bones, associated with osteogenesis imperfecta.

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