Topics Discussed: musculoskeletal injuries; musculoskeletal system.
Sections: Orthopedic Injuries: Introduction, The Immature Skeleton, Terminology, Physis Injuries, Clinical Evaluation, Management, Special Circumstances, Acknowledgment, References.
- Pediatric patients have unique patterns of injuries and fractures due to the immaturity of bone and the dynamic nature of skeletal growth. Fractures account for 10% to 15% of all childhood injuries.
- Fractures are more common than ligamentous injuries or sprains in children due to the relative weakness of the physis or growth plate.
- Injuries to the physis may lead to long-term growth abnormalities or growth arrest. Injuries to the physis occur in up to 18% of all pediatric fractures.
- Radiographs are more difficult to interpret and findings can be much more subtle in children than adults, as the physis is radiolucent and there are secondary ossification centers. Comparison views of the uninjured extremity can be helpful.
- The majority (75%) of physis fractures are Salter II fractures, and most of these are found after the age of 10 years.
- Up to 50% of fractures in children younger than 1 year are the result of nonaccidental trauma.
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