🦴 Chapter 724 · Common Fractures

Nelson Textbook of Pediatrics 22nd Edition | Pediatric fractures: buckle/torus (stable, 3-4 weeks healing), greenstick (unicortical), plastic deformation, Salter-Harris classification (I-V) for physeal injuries. Supracondylar humerus fracture — most common elbow fracture, risk of neurovascular injury (brachial artery, median nerve). Femur fractures — treatment by age (spica cast, flexible nails, rigid nails). Toddler's fracture — nondisplaced spiral tibia fracture in 1-4 year olds. Triplane/Tillaux — transitional fractures in adolescents. Child abuse — corner fractures, posterior rib fractures, femur fracture in non-ambulatory child.

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📋 30 Clinical Scenarios — Common Pediatric Fractures

📇 High‑Yield Review Cards

🩺 Clinical Recognition: Pediatric Fractures

Select a presentation to review diagnostic clues and management per Nelson Ch 724.

📋 Stepwise Management of Common Pediatric Fractures

🔑 Key Principles — Nelson Chapter 724
• Salter-Harris classification: Type I (physis only), II (physis+metaphysis, most common), III (physis+epiphysis), IV (all three, articular), V (crush).
• Remodeling potential: Greatest in young children, fractures near physis, and in plane of joint motion. Rotational deformity does NOT remodel.
• Supracondylar humerus: Most common elbow fracture in children. Displaced type III requires closed reduction and percutaneous pinning. Check for median nerve (AION) and brachial artery injury.
• Femur fractures: Age-based treatment: 0-2y → Pavlik harness/spica; 3-5y → spica cast; 6-10y → flexible nails; >11y → rigid nail.
• Toddler's fracture: Nondisplaced spiral tibia fracture in 1-4 years. Cast for 3 weeks. Often subtle on X-ray.
• Child abuse: Corner fractures, posterior rib fractures, femur fracture in non-ambulatory child (<18 months).

    ⚡ Reflex Prompts — Clinical Decisions

    📖 Summary: Common Fractures (Nelson 724)