fracture in children

2.  A fracture is a break in the continuity of
bone and is defined according to its type
and extent.
 Fracture is a break in any bone in the body.

3. 1. Clavicle fracture
2. Forearm fracture
3. Epiphyseal fracture
4. Fracture humerus
5. Femur fracture
6. Tibial fracture
7. Ankle fracture

4. 1. Based on Relationship with the Environment
2. Based on Displacement
3. Based on Fracture Pattern
4. Based on Etiology
5. Miscellaneous fractures

5. Classification Based on Relationship
with Environment
1. CLOSED
{Simple}
2. OPEN
{Compound}

6. a. CLOSED FRACTURE (simple fracture) is one that
does not cause a break in the skin.
b. AN OPEN FRACTURE (compound, or complex,
fracture) is one in which the skin or mucous membrane
wound extends to the fractured bone.
Open fractures are graded according to the following
criteria:
• Grade I is a clean wound less than 1 cm long.
• Grade II is a larger wound without extensive soft tissue
damage.
• Grade III is highly contaminated, has extensive soft
tissue damage, and is the most severe.

7. NON - DISPLACED FRACTURE
The bone cracks either part or all the way
through, but does not move and maintains
proper alignment
DISPLACED FRACTURE
The bone snaps into two or more parts and
moves so that the two ends are not lined up
straight

8. Classification: Based on Pattern
1. Transverse
2. Oblique
3. Spiral
4. Segmental

9. Transverse
Fracture
A fracture in which the
# line is perpendicular
to the long axis of the
bone
Oblique Fracture
A fracture in which the #
line is at oblique angle
(45)to the long axis of
the bone

10. Spiral Fracture
A severe form of
oblique fracture in
which the # plane
rotates along the long
axis of the bone.

11. Segmental
Fracture
There are two
fractures in one
bone, but at different
angles

12. 1. TRAUMATIC
2. PATHOLOGICAL
– Tumors
– Bone cysts
– Osteomyelitis
– Osteoporosis
– Rickets

13.  Buckle fracture-
results from
compression of
bone
 Greenstick
fracture- one side
of bone is broken
and other side is
bent.

14.  Impacted fracture-
a part of fractured
bone is driven into
another bone.
Comminuted
Fracture - The bone is
broken into many
fragments.

15.  Bend fracture- when
bone bends to a
breaking point and is
not straightened
completely without
intervention
 Compression
fracture- results
from
compression of
bone.

16. 1. Pain and tenderness
2. Loss of Function
3. Deformity
4. Shortening
5. Crepitus
6. Swelling and Discoloration

17. 1. History and Physical examination
2. Radiologic studies (X-ray, CT, MRI, Bone
scan)
3. Decreased movement of the limb
4. Crepitation
5. Arm is usually held across the chest with
the opposite limb used to support the
weight of injured limb

19. 1. Don't move the person except if necessary
to avoid further injury.
2. Stop any bleeding. Apply pressure to the
wound with a sterile bandage, a clean cloth
or a clean piece of clothing.
3. Immobilize the injured area. Don't try to
realign the bone or push a bone that's
sticking out back in. Apply a splint to the
area above and below the fracture sites.

20. 4. Apply ice packs to limit swelling and help
relieve pain. Don't apply ice directly to the
skin. Wrap the ice in a towel, piece of cloth
or some other material.
5. Treat for shock. If the person feels faint or
is breathing in short, rapid breaths, lay the
person down with the head slightly lower
than the trunk and, if possible, elevate the
legs.

21. The principles of fracture management
are,
1. Reduction,
2. Immobilization, And
3. Rehabilitation.

22. 1.Reduction
Reduction is the process of restoring the
bone ends into their normal anatomical
positions. This is accomplished by open or
closed manipulation of the affected area,
referred to as open reduction and closed
reduction.

23. 1. Closed reduction is accomplished by
bringing the bone ends into alignment by
manipulation and manual traction. A cast
is normally applied to immobilize the
extremity and maintain the reduction.
2. In open reduction, a surgical opening is
made, allowing the bones to be reduced
manually under direct visualization.
Internal fixation devices are used to
maintain the bone fragments in reduction.

24. 2. Immobilization - Immobilization is
done to maintain fracture reduction until
healing occurs.
Immobilization may be done by internal
fixation or external fixation.
1. Internal Fixation - Internal fixation devices
include pins, wires, screws, rods, nails, and
plates.
2. External Fixation - Methods include casts,
splints, pins and continuous traction.

30.  Traction is the use of weights, ropes
and pulleys to apply force to tissues
surrounding a broken bone.

32.  It is used when partial or temporary
immobilisation is required, and to provide
comfort following injury while awaiting
surgical fixation, especially in hip and
femur injuries.

33.  It is used for fractures of the tibia, and
works by supporting the flexed knee in a
sling and applying a horizontal pulling force
by use of traction tape and elastic bandage
attached to the lower leg.

34.  It is mainly used in young children who
have fractures of the femur or congenital
abnormalities of the hip. Both the patient's
limbs are suspended in the air vertically at a
ninety degree angle from the hips and
knees slightly flexed.

36.  It is used for fractures of the upper
extremities. It works in the form of
horizontal traction which is applied to
the abducted humorous, while vertical
traction is applied to the flexed forearm.

37.  It is used in cervical ailments and injuries. It
is usually used for shorter periods.
 Weight should not exceed 2.3 Kg. The
halter fits under the chin and around the
back of the head against the occipital
protuberance.

38.  Rehabilitation is the regaining of strength
and normal function in the affected area.
 Specific rehabilitation for each patient is
based on the type of fracture and the
methods of reduction and immobilization
used.

44.  An overhead
trapeze will facilitate
independent
movement in bed. It
also maintains range of
motion of the upper
extremities

45. Early complications
1. Neurovascular impairment
2. Fat embolism
3. Compartment syndrome
4. Constipation from immobility and
analgesics
5. Deep vein thrombosis

46. Delayed complications
1. Skin breakdown
2. Joint stiffness or
contractures
3. Delayed union 0r no union
4. Malunion