pediatric fracture

7/18/2019 Pediatric Fracture

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Pediatric FractureBuckle Torus, Greenstick, Salter Harris

Pediatric Fracture

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I. INTRODUCTION

o!ilit" is t#ea!ilit" to $o%e

&uickl" and easil"

to e%er"one,includin' c#ildren

(ractures inc#ildren)

1. $eta*#"sical

area+. dia*#"sis area

#at is t#edi-erence (ractures

in c#ildren andadults

Based on Riskesdas+/10 (raktur on a'e1 "ear /,02, 134

"ears 1,52, 6314"ears 4,62

7n" i$*act o(

(racture

Pediatric Fracture

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II. 8IT9R7TUR9 R9:I9;

7nato$" and P#"siolo'" Bone is co$*osed o( cells, $atri< *roteins and $ineral de*osits

cells osteo!lasts, osteoc"tes, osteoclasts

Pediatric Fracture

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Cartila'e

• 1. #"aline cartila'e

• +. Cartila'e elastin• 0. =!rocartila'e

0 kinds

o(cartila'e

• O**ositional Grot#

• Interstitial Grot#Cartila'e'rot#

Pediatric Fracture

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Bone Grot#

Bone t#ickness t#e !alance o( osteo!last andosteoclast

8on' !ones de*ands on e*i=sis

sti$ulate t#eacti%it" o(osteo!lasts

e*i*#"seal!one*roli(eration

sto* #en t#e

e*i*#"seal*lates *er(ectrein(orce$ent

Efecto

Growth

Hormon

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Di-erences in C#ild and

7dult Bone Re$odellin' cell acti%it" >>

!iolo'ical *lasticit"

8i'a$ent Periosteu$ t#icker

$ec#anical stren't# >>

Grot# Plate

Restin' ?one

Proli(eratin' ?one

H"*ertro*ic ?one

Calci=ed ?one

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Torus Fracture

I$*action in@ur" o(c#ild#ood

Pri$aril" a-ects

de%elo*in' $eta*#"seal!one.

Co$*ression (racturedue to *orous nature o(t#e !one.

Pediatric Fracture

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Inco$*lete (racture o( lon'!one t#at #a%ec#aracteristics corte<*rotrusion

Dia'nosis)

8ook, Feel, o%e

Treat$ent)

I$$o!ili?ation

Close Treat$ent

Traction

Pediatric Fracture



Greenstick Fracture

Greenstick (racture is a(racture occurrin' in t#ei$$ature !one. i$$ature!one is $ore e<i!le and #asa t#icker *eriosteu$ t#an$ature adult !one

#ic# t"*icall" results ininco$*lete !reaks in t#e s#a(to( a !one

7n inco$*lete (racture it# acortical !reak in t#e tensionside o( t#e !one

T#e corte< on t#e co$*ressionside under'oes *lasticde(or$ation !ut re$ains intact

Greenstick (ractures reect t#e*lia!ilit" o( a "oun' c#ilds!one

Pediatric Fracture

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Dia'nosis

Trau$a Histor"

P#"sical9<a$ination

Radiolo'"

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Treat$ent

Close Reduction and Castin'

Rotation and an'ulation 33 > lon' ar$ cast, e<ion,E//

7n'ulation 33 > Traction and Countertraction

Pediatric Fracture

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0 – 2 years old 2 – 3 weeks



> 10 years old 6 – 8 weeks



Pro'nosis

O(ten %er" eas" to reduceand i$$o!ili?e in a cast.

So$e (ractures re&uire

co$*letion o( t#e (racture*rior to reduction andi$$o!ili?ation.

T#e *ro'nosis is also %er"'ood (or t#ese t"*es o((ractures.

a" !e co$*licated !"recurrent de(or$it" #ilecasted

Pediatric Fracture

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162 to 0/2 o( all (ractures inc#ildren

*eak in adolescents

'rot# de(or$it" is rare,occurrin' in onl" 12 to 1/2 o(

all *#"seal in@uries.

P#"seal In@ur"

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P#"seal anato$"

ost in@uries occur @ust a!o%e area o(

*ro%isional calci=cation it#in t#e

#"*ertro*#ic ?one. Ger$inal la"er

(re&uentl" re$ains intact and attac#ed

to t#e e*i*#"sis

Pediatric Fracture

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CLASSIFICATION OF PHYSEAL INJUIES

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Salter Harris t"*e I

Trans%erse t#rou'#t#e entire *#"sis,it#out $eta*#"seal

(ra'$ent. ost co$$on

Closed reduction i(dis*laced.

Co$*lications ost #eal une%ent(ull"

Grot# slodonarrest

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Salter Harris t"*e II

e<tends *artiall"alon' t#e *#"seal3$eta*#"seal inter(ace,and t#en *ro*a'atesinto t#e $eta*#"sis.

ost co$$on a(ter 4"ears

Closed reduction.

Co$*lication) $a@orit"#eal it#outsi'ni=cantconse&uences.

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Salter Harris t"*e III

*ro*a'ates trans%ersel"alon' t#e *#"seal3$eta*#"seal inter(aceand cross t#e *#"sis,

e*i*#"sis, ossi=cationcenter and articularcartila'e unsta!le andintraarticular .

O*en reduction $a"necessar" it# internal

=<ation Co$*lication) Grot#

arrest an'ular de(or$it",osteoar#tritis, non union

Pediatric Fracture

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Salter Harris t"*e I:

intraarticular %ertical s*littin' o( all?ones o( t#e *#"sis.

O*en reduction $a"necessar" it#internal =<ation

Co$*lication) Grot#

arrest an'ularde(or$it",osteoar#tritis, nonunion

Pediatric Fracture

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Salter Harris t"*e :

•C3Crus# in@ur" to 'rot# *late.

Pediatric Fracture

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Pro'nosis

1. T"*e o( (racture.

T#e *ro'nosis (or eac# o( t#e =%e t"*es o( disc e*i*#"seal (racturesclassi=cation #as !een discussed a!o%e.

+. T#e a'e o( t#e c#ild.

C#ildren it# "oun'er a'e at t#e ti$e o( (racture ill #a%e 'reater 'rot#

0. T#e !lood su**l" to t#e e*i*#"sis

Interru*tion o( !lood su**l" to t#e e*i*#"sis associated it# *oor*ro'nosis.

4. Reduction et#ods

ani*ulation o( %er" lar'e on t#e dis*laced e*i*#"sis can da$a'e t#ee*i*#"seal disc is and t#ere(ore can en#ance 'rot# disorders.

6. T#e ound is o*en or closed

O*en e*i*#"seal (racture disc can lead to in(ection, #ic# in turn illda$a'e t#e disc and cause t#e cessation o( t#e 'rot# *rocess*re$aturel".

Pediatric Fracture

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T#ank ou. .

Pediatric Fracture

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pediatric fracture

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