One of the frequent reasons for consulting a paediatric orthopaedist is the orthopaedic traumas in childhood. Considering tendency of children to frequently get injured, it’s fortunate that they are robust and flexible. Thus they can come through many injuries with minor damages and generally do not require serious treatments.
Mild or serious, orthopaedic injuries in children shall be considered different from their equivalents in adults. Because, due to differences in anatomies and bone healing process of children, treatment and monitoring fractures shall be completely different from adults. The most remarkable feature of children bones is their capacity to self-correct. Thanks to the self-correcting ability of bones in childhood, we can monitored slightly skipped or angled bones without correction, provided that they are within the limits set by scientific studies. Naturally, these acceptable criteria depend on the bone fractured. The fractures we expect to heal themselves, the fixation of the fracture in its current state sometimes worries the parents. Therefore it is better to be in good communication with the paediatric orthopaedist to be better informed.
The age where musculoskeletal system trauma is most frequently seen is the adolescence. The most common fractures through the whole childhood are forearm/wrist fractures. A child with a fracture is first examined to acquaint with the anatomy of the child and this, sets up a good relation since this examination does not create any pain. While conducting advanced examinations, doctors experienced in child orthopaedics shall differentiate potentially fractured views with normal developmental cartilage plates and when necessary x-rays of the normal side shall also be taken for comparison.
Accurately diagnosed and suitably treated fractures generally heals without problems in childhood.
It’s a fracture specific to childhood. It’s a disposition seen due to bone periosteum being thick. It generally occurs when the bone is subjected to compressive loads and generally seen in areas close to joints. Misalignment risk is low, treatment is easy and generally heal smoothly.
Uncomplete fracture that can arise due to bone being subject to bending forces. It’s a fracture specific to childhood due to bone being flexible and periosteum being thick. Curvature of the bone can be observed from outside and while it’s generally only closely monitored, it may sometimes require correction.
Fractures related to growth cartilage
These are the fracture where the fracture line crosses the growth cartilage that plays a role in longitudinal growth of the bone. It shall be noted that the growth cartilage can be damaged and lose its functionality in such fractures and may lead to problems such as deformities or shortness and
In childhood, neck can be subject to stronger forces due to head to body ratio being skewed in favour of head in children. It shall be noted and peripheral nerve structures can also be affected in a neck fracture caused by this or a direct trauma.
Collarbone is the bone that is fractured most frequently at birth. It is treated with a simple bandage/dressing in neonates. It is a bone with high healing potential and it is generally properly healed with a simple fixation with suspenders even in older children.
Elbow area Fractures
It is generally seen in the elbow with a frequent swelling after a fall on hands or the elbow. Since the elbow area is an important junction area for main veins and nerve structures connecting to the hand, it shall be noted that such structures can also be damaged in such fractures.
While it can be treated only with bandage/dressing, there can be conditions that require urgent surgery. It shall also be known that following elbow fractures, after any suitable treatment, deformities an develop in the elbow during development of the child
While wrist fractures in childhood are generally healed with bandage/cast treatment, it may require treatment in rare cases.