Which of the following statements are true concerning fractures in the pediatric age group? Fractures are common among active children and often take on different characteristics from those seen adults.
A. When a bone is angulated beyond the limits of physiologic and structural (plastic) deformation, a buckle (or torus) fracture often occurs B. A Salter III fracture occurs through a portion of the physis and extends into a portion of the metaphysic C. An injury to the physis may result in an angular deformity, shortening of the bone, or both. D. The presence of anterior rib fracture in a child <3 years is highly suggestive of non-accidental trauma 5. A Salter IV fracture represents a crush injury to the physis, which may be difficult to detect on initial radiographic evaluation
An injury to the physis may result in an angular deformity, shortening of the bone, or both.-if partial closure of the physis occurs following an injury, an angular deformity often results, while complete closure results in shortening of the bone. the magnitude of the effect is dependent upon the particular physis that is injured, as well as the age of the child and the amount of potential growth that remains. although, when compared to adults, bones in children are capable of absorbing more energy before deformation and fracture occur, a greenstick not a buckle fracture may occur when the limits of deformation are exceeded. a salter i fracture is characterized by separation through the physis; a salter ii by a fracture through a portion of the physis extending through a portion of the metaphysis; a salter iii by a fracture through a portion of the physis extending through the epiphysis into the joint; a salter iv by a fracture across the metaphysis, physis and epiphysis; and a salter v by a crush injury to the physis, which is often not recognized on radiographs but only when premature physeal closure occurs. fractures that have a high probability of association with non-accidental trauma include metaphyseal lesions (bucket-handle and corner fractures), posterior rib fractures, and fractures of the scapula, spinous processes and sternum.
board testing point: understand radiographic findings associated with pediatric fractures.