Bones are children are quite different from adult bones anatomically as well as physiologically. They have a great healing power and often unite uneventfully with conservative and non operative methods. It is rare to find a fracture not uniting in case of paediatric fractures and whenever it occurs, there would be a strong reason for it like infection or some other pathology.
Fractures in children demand a special consideration.
Bones of children are softer and pliant as compared to adult bones. To compare imagine a twig and a hard stick. Because of this bones in children can absorb a greater trauma without getting fractured.
Periosteum- the layer that covers the bones is quite thick in comparison to adult periosteum. It is difficult to tear easily because of thickness and thus prevents displacement of fractured pieces.
Rate of healing of fracture is faster than that in adults. This rate decreases with age of the child.
Bones of children are in growing phase. This growth occurs at the bone ends which harbor a growth plate called physis. Physis is separated from joint by a bony tissue called epiphysis. Injury to this physis or growth plate is a peculiar phenomenon in children because the growth plate ceases to function and fuses with the bone after completion of growth. These injuries are called [tag-tec]Epiphyseal injuries[/tag-tec] and can result in stoppage of growth and bone shortening.
Greenstick fractures
As bones of children more pliable than adult bone, a fracture pattren may occur in which fracture is not complete. Such fracture are called Greenstick fractures. In this one side of the bone breaks and one side is bent.
The name for a greenstick fracture comes from the analogy of breaking a young, fresh tree branch. when you try breaking a fresh tree branch it snaps on the outer side of the bend while the inner side is bent, and still in continuity.
Though incomplete, the greenstick fracture must be bent back into the proper position and then plaster should be applied for appropriate time so as to maintain the position till the fracture unites.
I am trying to find the protocal for how many xrays a 13 year old child should have after breaking his radius and ulnar bones.We seem to be having weekly xrays,
Dr Arun Pal Singh Reply:
October 14th, 2011 at 3:34 pm
@frances cherry,
The bone should unite in 4-6 weeks.
Weekly xrays may be done where redisplacement of the fracture is a concern.
How much time has passed since injury.