Pediatric Fractures
Pediatric fractures, or broken bones in children, differ significantly from fractures in adults due to the unique characteristics of a child's growing bones. Children have growth plates (physes), which are areas of developing cartilage tissue near the ends of long bones. These growth plates are weaker than the surrounding bone and are often the site of fractures in children. Understanding the types, causes, treatment, and complications of pediatric fractures is crucial for proper management and ensuring optimal healing.
Key Features and Symptoms of GOUT
Greenstick Fractures:
- A greenstick fracture occurs when a bone bends and cracks on one side but does not break completely through. This is common in children due to their more flexible bones.
- Forearm bones (radius and ulna).
Buckle (Torus) Fractures:
- A buckle fracture is an incomplete fracture where one side of the bone is compressed, causing it to buckle or bulge outward. This type is typically stable and heals quickly.
- Forearm bones, especially after a fall on an outstretched hand.
Growth Plate (Physeal) Fractures:
- Growth plate fractures involve the physis and are unique to children. They can have serious consequences if not treated properly, as they may affect future bone growth.
- The Salter-Harris classification system is used to describe the severity and type of growth plate fractures:
Type I: A fracture through the growth plate.
Type II: A fracture through the growth plate and metaphysis (the bone shaft).
Type III: A fracture through the growth plate and epiphysis (the end of the bone).
Type IV: A fracture through the growth plate, metaphysis, and epiphysis.
Type V: A crush injury to the growth plate.
Complete Fractures:
- A complete fracture occurs when the bone is broken all the way through. These can be further classified based on the fracture pattern (e.g., transverse, oblique, spiral).
Plastic Deformation:
- Unlike adults, children's bones can bend without breaking. Plastic deformation occurs when the bone bends but does not return to its normal shape, leading to a permanent deformity.
Causes of Pediatric Fractures
Falls:
- Falls are the most common cause of fractures in children, especially from playground equipment, bikes, or while playing sports.
Sports Injuries:
- Contact sports, gymnastics, and activities like skateboarding or skiing can lead to fractures, particularly in the arms and legs.
Trauma:
- Car accidents, pedestrian injuries, or falls from heights can cause more severe fractures.
Non-Accidental Trauma:
- In some cases, fractures in young children may be the result of child abuse. Spiral fractures and fractures in unusual locations may raise suspicion.
Treatment
Immobilization:
- Casting or Splinting: Most pediatric fractures are treated with immobilization using a cast or splint. This allows the bone to heal while keeping it in the correct position.
- Duration: The duration of immobilization varies depending on the type of fracture, the child's age, and the bone involved. Generally, children's bones heal faster than adults.
Reduction:
- Closed Reduction: If the bone is displaced, a closed reduction (manipulation without surgery) may be necessary to realign the bone before casting.
- Open Reduction and Internal Fixation (ORIF): In cases of severe fractures or those involving the growth plate, surgery may be required to realign and stabilize the bone using pins, screws, or plates.
Surgical Intervention:
- Surgery is indicated for complex fractures, fractures that cannot be reduced closed, or fractures involving significant growth plate disruption.
Pain Management:
- Medications: Pain relief is usually managed with over-the-counter pain medications like acetaminophen or ibuprofen. Stronger pain relief may be necessary after surgery.
Rehabilitation:
- Physical Therapy: After immobilization, physical therapy may be necessary to restore strength, flexibility, and function to the affected area.
If you would like to have additional information contact Dr. Vipul Shet, serving communities and people from all walks of live.
