By Neil E. Green MD, Marc F. Swiontkowski MD
This absolutely revised and up-to-date pediatric spouse to SKELETAL TRAUMA, third variation, provides the main complex concepts for coping with musculoskeletal accidents in kids and teens - emphasizing the epidemiology, mechanisms, administration, and demanding situations certain to this inhabitants. the world over well-known authors current assurance of development and improvement, pathology, problems, baby abuse, and nearly each attainable damage from head to foot. This third version comprises 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 presents a broader point of view on surgical administration.
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Additional resources for Skeletal Trauma in Children, Volume Three
Z. Fractures of the epiphyseal plate. Clin Orthop 41:24–32, 1965. 18. A. Anatomy and physiology of skeletal development. , ed. Skeletal Injury in the Child. Philadelphia, Lea & Febiger, 1982, pp. 16–40. 19. A. Growth slowdown and arrest lines. J Pediatr Orthop 4:409–415, 1984. 20. A. Injury to growth mechanisms of the immature skeleton. Skeletal Radiol 6:237–253, 1963. 21. A. The uniqueness of growing bones. , eds. Fractures in Children, Vol. 3. B. Lippincott, 1984, pp. 1–86. 22. Rang, M. Injuries of the epiphysis, growth plate and perichondrial ring.
24. P. Cellular response to fracture studied with tritiated thymidine. J Bone Joint Surg Am 43:352–362, 1961. 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.
A small, smooth pin placed perpendicularly across the center of the physis for a short time (2 to 3 weeks) rarely causes growth arrest; however, a threaded wire placed obliquely across a physis and left in place for a few weeks usually results in a bony bar. Commonly Associated Injuries Injuries most commonly associated with physeal fractures are those to the neurovascular and ligamentous structures near the physis. Avulsion of the physis as a result of ligamentous injury occurs most often at the tibial spine, at the ulnar styloid, and in the phalanges.