Yeditepe University Faculty of Medicine Pediatric Fractures Turhan Özler MD Yeditepe University Faculty of Medicine Department of Orthopaedics & Traumatology

FEUTURES 1- Plastic deformation. 2- Thick periost and shorter healing time. 3- Remodeling. 4- Lower nonunion rate.

Fracture in Children Plastic deformation Radius and ulna Reduction should be done >20° >4 years Restriction of pronation/supination

Greenstick fracture Cortex is broken at tension site but intact at compression site Treatment: Reduction + casting

Torus Fracture Axiel compression cause torus fracture Metaphizo-diapfizer site Rediographic aperrance is cortical precence No need reduction + casting

Epiphyseal fracture

Kemik büyümesinin anlaşılması ortopedinin temel konusudur

Damarsal yapı Epifiziyel arter Perikondral arter Temel besleyici arter The Ciba collection Volum 8; p.166

Artiküler kıkırdak Articular cartilage Transformed into Epiphyseal Growth plate (poorly organized) Transformed into Tidemark at maturity Secondary Ossification center 1st Cribiform Epiphyseal artery F. Netter, 1990

Salter Harris Classification Tip1: The epiphysis is completely separated from the end of the bone. Tip2: The epiphysis, together with the growth plate, is partially separated from the metaphysis, which is cracked. Tip3: fracture runs completely through the epiphysis and separates part of the epiphysis and growth plate from the metaphysis. Tip4: This fracture runs through the epiphysis, across the growth plate, and into the metaphysis. Tip5:The growth plate is compressed.

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Indications for Open Reduction Open fractures Inability to maintain acceptable reduction Multiple trauma Elastic nail fixation can often be accomplished with little soft tissue disruption

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