Low subcondylar fractures are the most common and are incomplete greenstick fractures the majority of the time. There are 3 types of condylar fractures. Condylar fractures are the most common pediatric mandibular fractures, accounting for up to 55% of all mandibular fractures. For example, greenstick fractures can occur in the jaw and nose. Greenstick fractures can also occur in the face, chest, scapula, and virtually every bone in the body, but with much less frequency than long bones. This is because people brace falls with an outstretched arm, resulting in fractures to the upper extremities. Most commonly, they occur in the forearm and arm, involving either the ulna, radius, or humerus. They occur most often in long bones, including the fibula, tibia, ulna, radius, humerus, and clavicle. Ī greenstick fracture is a partial thickness fracture where only the cortex and periosteum are interrupted on one side of the bone but remain uninterrupted on the other. Ī greenstick fracture is a partial thickness fracture where only the cortex and periosteum are interrupted on one side of the bone while they remain uninterrupted on the other side. These fracture patterns include greenstick, torus, and spiral injuries, which are bending injuries rather than full-thickness cortical breaks. These and other qualities of the pediatric periosteum, as well as the increased compliance of the pediatric bone, are responsible for the unique fracture patterns seen in pediatric patients. Furthermore, the pediatric periosteum is more active, thicker, and stronger in children, which greatly decreases the chance of open fractures and fracture displacement. Due to their increased compliance, pediatric bones tend to have more bowing and bending injuries under stress that would cause a fracture in an adult bone. Therefore, prior to ossification, the majority of pediatric bone is just calcified cartilage, which is very compliant when compared to the ossified bones of adults. The calcified cartilage breaks down, allowing for vascular invasion and osteoblastic/osteoclastic bone matrix deposition and remodeling. The physis is split into 4 zones: (1) the reserve or resting zone, which is made up of hyaline cartilage (2) the zone of proliferation, which is made up of multiplying chondrocytes that arrange into lacunae (lakes) (3) the zone of hypertrophy, where the chondrocytes stop dividing and start enlarging and (4) the zone of calcification, where minerals are deposited into the lacunae to calcify the cartilage. However, long bones like the phalanges have only one physis. Long bones like the femur have 2 physes separated by a diaphysis, which is the shaft of a long bone. The physis is located towards the end of the long bone, with the epiphysis above it and the metaphysis below it. It allows for bone growth from a cartilage base, known as endochondral ossification, which differs from bone growth from mesenchymal tissue or intramembranous ossification. The physis is the growth plate in long bones, including phalanges, fibula, tibia, femur, radius, ulna, and humerus. The majority of differences between adult and pediatric skeletal systems are due to the open physis in the pediatric population, which allows for continued growth prior to skeletal maturation during puberty and adulthood. A torus is the convex portion of the upper part of the base of a Greek column and resembles the appearance of the cortical buckling seen in the "column" of bone which has been fractured in the pattern discussed in this article.The makeup, anatomy, and histology of the pediatric skeletal system is not just a smaller version of the adult form rather, it is unique in that it allows for rapid growth and change throughout development from childhood to adulthood. The term torus is the Latin word meaning protuberance. Sometimes a cast may be applied, but often a splint is all that is required with a period of rest and immobilization. They are self-limiting and typically do not require operative intervention, although a manipulation may be required if the angulation is severe. In some cases, angulation is the only diagnostic clue Subtle deformity or buckle of the cortex may be evident This most commonly occurs at the distal radius or tibia following a fall on an outstretched arm the force is transmitted from carpus to the distal radius and the point of least resistance fractures, usually the dorsal cortex of the distal radius. Cortical buckle fractures occur when there is axial loading of a long bone.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |