Fracture and Cast Care in Pediatric Clients

Key Differences from Adult Clients

• Healing Rate: Broken bones heal faster in children than in adults.

Types of Fractures

• Closed Fracture: Skin remains intact.
• Open Fracture (Compound): Skin is broken, bones protrude, high risk for infection (e.g., osteomyelitis).
• Complete Fracture: Bone is broken all the way through.
• Incomplete Fracture (Greenstick): Partially through the bone, common in children.
• Spiral Fracture: Results from twisting motion, common in child abuse; report to authorities.
• Oblique Fracture: Fracture at an angle.
• Compression (Impact) Fracture: Bones are compressed, can happen after a fall or jump.
• Crushing/Compression Fracture: Bones crushed under heavy object, risk of fat embolism.

Important Fracture Types to Focus On

• Spiral Fracture: Indicator of child abuse in pediatrics.
• Crushing/Compression Fracture: Think of a deadly fat embolism risk.
• Open Fracture/Compound: Higher infection risk due to broken skin.

Causes and Risks of Fractures

• Bed Rest: Long-term effects include bone fractures and muscle atrophy.
• Osteoporosis: Bones become weak and porous.
• Steroid Use (ending in -zone): Weakens bones.
• Trauma: Falls, like off a bicycle.

Signs and Symptoms of Fractures

• Common Symptoms: Pain, swelling, bruising, crepitus (grinding sound), and muscle spasms.
• Priority Finding: Internal bleeding indicators such as hypotension, tachycardia, and hematuria.

Priority Findings and Conditions

• Basilar Skull Fracture: CSF drainage from the nose (rhinorrhea), priority patient.
• Spinal Fracture (T6 or higher): Monitor for neurogenic shock; look for hypotension and bradycardia.
• Mandibular Fracture: Look for bleeding and drooling; suction mouth and oropharynx to protect the airway.
• Hip Fractures: Shortening of the leg on the affected side due to muscle spasms, bruising, groin, and hip pain.

Questions from ATI

1. 2-year-old Child Abuse Indicator: Humorous fracture due to a spiral fracture.
2. 8-year-old Greenstick Fracture: Incomplete fracture, partially through the bone.

Key Points for Bucks Traction

• Uneven limbs, such as a fracture causing one arm to be shorter than the non-injured arm.

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Additional Instructions

• Make sure to complete the quiz and download study guides.
• Share resources with classmates and instructors.

Conclusion

• Review all key points for understanding fractures and their implications in pediatric care.