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Principles of Pediatric Fractures

Principles of Pediatric Fractures - PediatricFractures...

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Principles of management Pediatric Fractures Mamoun Kremli Riyadh, Saudi Arabia Orthokids International Symposium Riyadh,  2007 مممممم مممممم مممم ممم
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Objectives Statistics about fractures in children How children’s bones are different Outline principles of management Point out specific precautions Acknowledgement and recommendation                   Lynn T Staheli
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introduction In Middle East ~60% of population are < 20 yrs. Fractures account for ~15% of all injuries in children. Different from adult fractures Vary in various age groups                            ( Infants, children, adolescents )
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Statistics ~ 50% of boys and 25% of girls, expected to have a fracture during  childhood. Boys > girls Rate increases with age. Mizulta, 1987
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Statistics ~ 50% of boys and 25% of girls, expected to have a fracture during  childhood. Boys > girls Rate increases with age. Physeal injuries    with age. Mizulta, 1987
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Statistics Most frequent sites (sample of 923 children, Mizulta, 1987)
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Why are children’s fractures different? Children have different physiology and anatomy Growth plate. Bone. Cartilage. Periosteum. Ligaments. Age-related physiology
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Why are children’s fractures different? Children have different physiology and anatomy Growth plate: In infants, GP is stronger than bone                    increased diaphyseal fractures Provides perfect remodeling power. Injury of growth plate causes deformity. A fracture might lead to overgrowth.
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Why are children’s fractures different? Children have different physiology and anatomy Bone: Increased collagen: bone ratio           - lowers modulus of elasticity
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Why are children’s fractures different? Children have different physiology and anatomy Bone: Increased collagen: bone ratio           - lowers modulus of elasticity Increased cancellous bone           - reduces tensile strength          - reduces tendency of fracture to propagate                 less comminuted fractures Bone fails on both tension and compression           - commonly seen “buckle” fracture
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Why are children’s fractures different?
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