Common Pediatric Fractures Research Articles

Common pediatric fractures and dislocations

Orthopedic injuries in children are a common chief complaint in our emergeney department. Due to the unique characteristies of the growing bone, pediatric fracture patterns differ from those in adults. In this article, common pediatric orthopedic injury patterns, their potential complications, and treatment are diseussed.

Pediatric ankle fractures: evaluation and treatment.

Pediatric ankle fractures account for approximately 5% of pediatric fractures and 15% of physeal injuries. The biomechanical differences between mature and immature bones, as well as the differing forces applied to those bones, help explain the differences between adult and pediatric fractures. The potential complications associated with pediatric ankle fractures include those seen with adult fractures (such as posttraumatic arthritis, stiffness, and reflex sympathetic dystrophy) as well as those that result from physeal damage (including leg-length discrepancy, angular deformity, or a combination thereof). The goals of treatment are to achieve and maintain a satisfactory reduction and to avoid physeal arrest. A knowledge of common pediatric ankle fracture patterns and the pitfalls associated with their evaluation and treatment will aid the clinician in the effective management of these injuries.

Pediatric Lisfranc injury: "bunk bed" fracture.

A common pediatric fracture is often overlooked due to the subtle deformity of the proximal first metatarsal. The injury is produced during a fall from a height, resulting in a flexion force that wedges the oblique first cuneiform-first metatarsal epiphysis into the first metatarsal-second metatarsal interspace. The injury is more severe than indicated by the bone injury, in that ligaments are involved in subluxation. Anatomic features of the first metatarsal-first cuneiform area present a suitable site for the described injury to occur. The pathogenesis of adult Lisfranc tarsometatarsal dislocation is the model for the pediatric equivalent. The clinical, physical, and radiologic findings of 16 patients are reviewed.