Page 120 - C:\Users\cbaro\OneDrive\Documents\Flip PDF Professional\Study Guide for the Orthopaedic Technology Certification Exams\

casting and bracing techniques for these age groups. Mastering these principles ensures
effective and safe orthopaedic care for both young and elderly patients.

Pediatric-Specific Fracture Management and Growth Plate

Injuries

1. Unique Considerations in Pediatric Fractures

Fractures in children differ from those in adults due to their growing bones, flexible
periosteum, and active growth plates (physes). These differences influence fracture healing,
treatment choices, and potential complications.

• Stronger Periosteum: Pediatric bones have a thicker periosteum, providing greater healing
potential and the ability to remodel fractures.
• Growth Plates (Physis): Fractures involving the growth plate can disrupt bone development,
potentially leading to limb length discrepancies or angular deformities.
• Higher Bone Plasticity: Pediatric bones are more pliable, often resulting in torus (buckle) or
greenstick fractures rather than complete breaks.

2. Salter-Harris Classification of Growth Plate Fractures

Growth plate fractures are classified using the Salter-Harris system, which helps guide
treatment decisions.

• Type I: Fracture through the growth plate (physis) without bone displacement.
• Type II: Fracture through the physis and metaphysis (most common type).
• Type III: Fracture through the physis and epiphysis, potentially affecting joint surfaces.
• Type IV: Fracture through the metaphysis, physis, and epiphysis, requiring precise reduction.
• Type V: Compression (crush) injury of the growth plate, leading to high risk of growth
disturbance.

3. Common Pediatric Fractures and Their Management

• Torus (Buckle) Fracture: Incomplete fracture due to axial loading; managed with short
immobilization.
• Greenstick Fracture: Partial break on one side of the bone; often requires casting.
• Supracondylar Humerus Fracture: Common in children; may require reduction and
percutaneous pinning.
• Clavicle Fracture: Typically treated conservatively with a sling or figure-eight brace.
• Toddler’s Fracture: Spiral fracture of the tibia, often requiring a long leg cast.