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1、FracturesinChildrenMamounKremliMamounKremli1FracturesinChildrenGeneralPrinciplesImmatureskeletondiffersfromthatoftheadultinboththenormalandpathologicalstates.Capableofplasticdeformationbeforetheyfail.Comminutedfracturesarerare.MamounKremli2FracturesinChildrenGeneralPrinciples
2、Failureofunionisrare.Fewfracturesrequireoperativetreatment.Presenceofgrowthplatepresentsachallengetothesurgeon.Specialconsiderations:PathologicalfracturesChildabuseMamounKremli3FracturesinChildrenGeneralPrinciplesDevelopmentandGrowthAfractureinanimmaturebonecancausegrowthtosp
3、eeduporslowdown.Fractureshealveryrapidly.Dependingontheageofthechildanddirectionofthedeformity,canremodelwithcorrectionofmostangularmalunion.Mostimportantareaofinjuryis“physis”.MamounKremli4FracturesinChildrenGeneralPrinciplesRegulationofEpiphysealGrowthPhysisistheprimarycent
4、reforgrowthinmostbones.Fourfunctionalzones:Growth.Matrix.Transformation.Remodeling.MamounKremli5FracturesinChildrenGeneralPrinciplesRegulationofEpiphysealGrowthPhysisrespondstocompressionaswellasdistraction.Otherstimulitogrowthareinsultsfrom:Implants.Fractures.Infections.Repe
5、atedattemptsatreduction.MamounKremli6FracturesinChildrenGeneralPrinciplesGrowthandRemodelingoftheMetaphysealBoneZoneoftransitionbetweenthephysisanddiaphysis.Siteofmostrapidchangesinbonestructure.MamounKremli7FracturesinChildrenGeneralPrinciplesSkeletaltraumaaccountsfor10-15%o
6、fallchildhoodinjuriesPhysealdisruptionsmakeabout15%ofallskeletalinjuriesinchildrenMamounKremli8FracturesinChildrenOverallFrequencyofFracturesPercentageofchildrensustainingatleastonefracturefrom0to16yearsofage:Boys42%Girls27%Percentageofchildrensustainingafractureinoneyear:1.6
7、–2.1%Percentageofchildrenwhoarehospitalizedbecauseofafracture:Duringentirechildhood(0to16y)6.8%Eachyear0.43%MamounKremli9FracturesinChildrenMamounKremli10FracturesinChildrenMamounKremli11FracturesinChildrenGeneralPrinciplesIncidenceofFractureTypeInonestudy30%involvedthephysis
8、.Ofallphysealinjuries,50%occurinthedistalradius.Secondmostcommonlyin
