By Neil E. Green MD, Marc F. Swiontkowski MD
This totally revised and up-to-date pediatric spouse to SKELETAL TRAUMA, third variation, offers the main complicated concepts for dealing with musculoskeletal accidents in young ones and youngsters - emphasizing the epidemiology, mechanisms, administration, and demanding situations particular to this inhabitants. the world over well-known authors current assurance of development and improvement, pathology, issues, baby abuse, and virtually each attainable harm from head to foot. This third variation contains the newly built means of utilizing versatile intramedullary nails within the administration of fractures to the femur and tibia. a brand new bankruptcy on anesthesia offers a broader point of view on surgical administration.
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Extra info for Skeletal Trauma in Children, Volume Three
10. M. Overgrowth of the femur after fractures of the shaft in childhood. J Bone Joint Surg Br 58:339–346, 1976. 11. A. Enhancement of fracture-healing. J Bone Joint Surg Am 77:940–953, 1995. 12. A. The growth of long bones in childhood. Arch Intern Med 38:785–793, 1926. 13. M. Undiagnosed fractures in severely injured children and young adults: Identification with technetium imaging. J Bone Joint Surg Am 76:561–572, 1994. 14. ; Apthorp, J. Analysis of 429 fractures in 189 battered children. J Pediatr Orthop 51:722–741, 1941.
This zone appears to be the weakest part of the physis. Harris demonstrated that when the proximal tibial epiphysis is separated from the metaphysis, the plane of cleavage consistently passes through this third zone. The fourth zone is reinforced by calcification but is still weaker than the first and second zones. Fractures generally involve the third and fourth zones. Trabecular formation in the metaphysis also contributes to the strength of the physis, but the metaphysis is susceptible to compression or torus forces.
19 Chapter 2 Physeal Injuries S. D. The physes appear to be the weakest area in children's bones, and they are also the structures that must be preserved if normal growth is to occur. It is mandatory to treat all physes as gently as possible and to delay prognosis until the time for growth disturbance has passed. Just as all children are different, injuries to different physes respond differently. Each physeal injury must be approached as a distinct entity, with the patient's age, the location of the injury, the type of injury, the growth potential of the affected area, the degree of displacement, and the time from injury to treatment kept in mind.
Skeletal Trauma in Children, Volume Three by Neil E. Green MD, Marc F. Swiontkowski MD