fractures ksu小儿骨折堪萨斯州立大学课件

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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