Common Pediatric Fractures

Prof. Mamoun Kremli Dr. Tarif AlAkhras

Objectives

• How are children’s fractures different
• Discuss common fractures in children
  • X-ray diagnosis
  • Principles of management
• Identify Epiphyseal injuries
• Precautions

Treatment Approaches in pediatric fractures

Common Pediatric Injuries

• Physeal (Growth Plate) Injuries

• Clavicle Fractures

• Supracondylar Humerus Fractures

• Forearm Fractures - Radius and Ulna

• Femur Fractures

• Non-accidental injuries

Summary

• Fractures in children are common
• Closed reduction is good
• Surgery might be needed
• Supracondylar humerus needs urgent attention
• Epiphyseal injuries ⇒ Growth Arrest
• Beware: Non-accidental injuries & Tumors

How Children’s Fractures Differ from Adults

Anatomical Differences

• Ends of long bones have thick cartilage:
  • Not seen on x-rays
• Growth plate:
  • Good remodeling. Special injuries
• More elastic, more cancellous:
  • → Incomplete fractures, simple fractures
• Periosteum:
  • Thick, good blood supply → Heal well & quickly

The Power of Remodeling

• ✓ Accept more angulation and displacement
• Better remodeling near growth plates
• Rotational mal-alignment does not remodel

Femoral Shaft Displacement Example

“We accept it in children, but in adults we don’t”

Age-Specific Fracture Patterns

• Varies in various age groups

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Fracture Types Specific to Children

• Greenstick - only on cortex
• Torus (buckle) - Compression on one side
• Plastic deformation - abnormal shape without fracture line
• Physeal injuries

phyuseal injuries

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