Emergency department evaluation and treatment of pediatric orthopedic injuries

Matthew D Thornton; Karen Della-Giustina; Paul L Aronson

doi:10.1016/j.emc.2014.12.012

Emergency department evaluation and treatment of pediatric orthopedic injuries

Emerg Med Clin North Am. 2015 May;33(2):423-49. doi: 10.1016/j.emc.2014.12.012.

Authors

Matthew D Thornton¹, Karen Della-Giustina², Paul L Aronson³

Affiliations

¹ Department of Emergency Medicine, Bay State Medical Center, 759 Chestnut Street, Springfield, MA 01199, USA.
² Department of Emergency Medicine, Bridgeport Hospital, 267 Grant Street, Bridgeport, CT 06610, USA. Electronic address: karendg@me.com.
³ Department of Pediatric Emergency Medicine, Yale New Haven Childrens Hospital, 100 York Street, Suite 1F, New Haven, CT 06511, USA.

PMID: 25892730
DOI: 10.1016/j.emc.2014.12.012

Abstract

Orthopedic injuries in children are unique when compared to those of adults because of the physiologic differences, especially the growth plates, stronger periosteum, and dynamic state of growth. The approach to the orthopedically injured child requires a gentle yet thorough focus with consideration of the growth plates as a primary area of weakness and growth when the child sustains an injury. Understanding the developmental stages of bones is paramount to being able to manage any injuries. Finally, what appears to be a benign injury may portend more serious issues, because nonaccidental trauma must always be considered in the evaluation of the injured child.

Keywords: Fracture; Growth plate; Pediatric orthopedics; Physis; Salter-Harris.

Publication types

Review

MeSH terms

Adolescent
Child
Child Abuse
Child, Preschool
Emergency Service, Hospital*
Female
Fractures, Bone* / diagnosis
Fractures, Bone* / therapy
Humans
Infant
Joint Dislocations / diagnosis
Joint Dislocations / therapy
Joints / injuries
Male
Musculoskeletal Diseases / diagnosis
Musculoskeletal Diseases / therapy
Orthopedics / methods*