Chapter 7 - Pediatric orthopedic emergencies

Summary

This chapter presents the key facts, description, physical examinations, epidemiology, initial evaluation, tests, treatment, and prognosis of pediatric orthopedic fractures such as growth plate injury, Osgood-Schlatter disease, child abuse/non-accidental trauma, spinal cord injury without radiographic abnormality (SCIWORA), transient synovitis, and slipped capital femoral epiphysis (SCFE). Bones in children remodel at a more rapid rate than adults, making closed reduction a viable treatment modality for many fractures that would require operative repair in adults. Treatment involves splinting or casting for 4 weeks and outpatient orthopedic follow-up. Some centers immobilize for even shorter periods with similar results. Casting is the treatment of choice and these injuries rarely need operative repair. Plain radiographs are the screening test of choice for SCFE. An MRI may be used for patients whose initial radiographs are inconclusive and there is a high degree of suspicion.